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Individual
MRS. MARISSA BETANCOURT
Active
Individual
MRS. MARISSA BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCP, LPC, CAADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0678095246
CNA
PA
01
—
1308
CAADC
PA
01
—
14443405
CAQH
—
01
—
6535041
ACA
—
01
—
PC011255
LPC
PA
Enumeration date
04/10/2019
Last updated
04/17/2019
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