Provider Demographics
NPI:1871299123
Name:ROBERTS, BETTY (LPC-A)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3042
Mailing Address - Country:US
Mailing Address - Phone:325-696-0457
Mailing Address - Fax:806-743-3118
Practice Address - Street 1:1650 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3042
Practice Address - Country:US
Practice Address - Phone:325-696-0457
Practice Address - Fax:806-743-3118
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional