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Individual

THOMAS A BETTIS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSCSW

Contact information

Practice address
5200 W 94TH TER, SUITE 105, PRAIRIE VILLAGE, KS 66207-2502
(913) 649-5567
(913) 649-7563
Mailing address
5200 W 94TH TER, SUITE 105, PRAIRIE VILLAGE, KS 66207-2502
(913) 649-5567
(913) 649-7563

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1373
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27178201
BCBS
KS
Enumeration date
05/16/2007
Last updated
05/26/2011
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