Provider Demographics
NPI:1881957744
Name:SANFORD-JOSEPH, BETTYE JEAN (MS, LPCA)
Entity type:Individual
Prefix:MS
First Name:BETTYE
Middle Name:JEAN
Last Name:SANFORD-JOSEPH
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 PEDEN ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-4420
Mailing Address - Country:US
Mailing Address - Phone:910-276-9299
Mailing Address - Fax:
Practice Address - Street 1:713 PEDEN ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4420
Practice Address - Country:US
Practice Address - Phone:910-276-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8618101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health