Provider Demographics
NPI:1043747603
Name:HENRY, BETSY-ANN (LCSW)
Entity type:Individual
Prefix:
First Name:BETSY-ANN
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 N 47TH ST APT 905
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1567
Mailing Address - Country:US
Mailing Address - Phone:718-790-3533
Mailing Address - Fax:
Practice Address - Street 1:161 WILMINGTON W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9041
Practice Address - Country:US
Practice Address - Phone:302-623-4593
Practice Address - Fax:302-623-4511
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136718104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker