Provider Demographics
NPI:1801949201
Name:MENDELSON, BETSY TAYLOR (MSW)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:TAYLOR
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 OLD FARM WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-1732
Mailing Address - Country:US
Mailing Address - Phone:978-465-0398
Mailing Address - Fax:
Practice Address - Street 1:55 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2628
Practice Address - Country:US
Practice Address - Phone:978-462-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1040381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical