Provider Demographics
NPI:1871760850
Name:GABHART, BETTY (LSW, LCAC)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:GABHART
Suffix:
Gender:F
Credentials:LSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-4031
Mailing Address - Country:US
Mailing Address - Phone:812-288-4449
Mailing Address - Fax:
Practice Address - Street 1:525 E 7TH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-4031
Practice Address - Country:US
Practice Address - Phone:812-288-4449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3300547A104100000X
IN87000733A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)