Provider Demographics
NPI:1750117636
Name:BETANCES, RAYSA (LMSW)
Entity type:Individual
Prefix:
First Name:RAYSA
Middle Name:
Last Name:BETANCES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 225TH ST APT 23F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5023
Mailing Address - Country:US
Mailing Address - Phone:646-244-4619
Mailing Address - Fax:
Practice Address - Street 1:150 W 225TH ST APT 23F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5023
Practice Address - Country:US
Practice Address - Phone:646-244-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122483-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker