Provider Demographics
NPI:1801699111
Name:MCBETH, LATOYA
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:MCBETH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 HADDINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-2781
Mailing Address - Country:US
Mailing Address - Phone:864-814-9638
Mailing Address - Fax:
Practice Address - Street 1:6031 HADDINGTON DR
Practice Address - Street 2:
Practice Address - City:ROEBUCK
Practice Address - State:SC
Practice Address - Zip Code:29376-2781
Practice Address - Country:US
Practice Address - Phone:864-814-9638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17663104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker