Healthcare Provider Details

I. General information

NPI: 1043747603
Provider Name (Legal Business Name): BETSY-ANN HENRY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W 14TH ST STE 1E40
WILMINGTON DE
19801-1013
US

IV. Provider business mailing address

503 LAGRANGE AVE
ESSINGTON PA
19029-1111
US

V. Phone/Fax

Practice location:
  • Phone: 302-320-2100
  • Fax: 302-320-2121
Mailing address:
  • Phone: 718-790-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW23271
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: