Individual
KATIE BETTENCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2068 S EAGLE RD, MERIDIAN, ID 83642-6707
(208) 340-1688
(208) 887-3660
Mailing address
2068 S EAGLE RD, MERIDIAN, ID 83642-6707
(208) 340-1688
(208) 887-3660
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
8911028
ID
1041C0700X
Clinical Social Worker
Primary
8911028
ID
Other
Enumeration date
06/07/2022
Last updated
11/03/2025
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