Provider Demographics
NPI:1932350295
Name:DELONG, BETTINA (LPC)
Entity Type:Individual
Prefix:MS
First Name:BETTINA
Middle Name:
Last Name:DELONG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:BETTINA
Other - Middle Name:
Other - Last Name:DELONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:39 RUSH HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3227
Mailing Address - Country:US
Mailing Address - Phone:281-363-1199
Mailing Address - Fax:
Practice Address - Street 1:10655 SIX PINES DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1444
Practice Address - Country:US
Practice Address - Phone:281-292-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health