Healthcare Provider Details

I. General information

NPI: 1417047150
Provider Name (Legal Business Name): BETTE B. BETTS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 MARQUEZ PL SUITE 211 A
SANTA FE NM
87505-1834
US

IV. Provider business mailing address

1920 TIJERAS RD
SANTA FE NM
87505-3352
US

V. Phone/Fax

Practice location:
  • Phone: 505-310-1074
  • Fax: 505-992-6145
Mailing address:
  • Phone: 505-310-1074
  • Fax: 505-992-6145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-1698
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: