Healthcare Provider Details

I. General information

NPI: 1962851535
Provider Name (Legal Business Name): TERRA BETTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRA MARIE BETTERS LPC, NCC

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 JEFFERSON STEET
MCKEESPORT PA
15132
US

IV. Provider business mailing address

819 JEFFERSON ST
MCKEESPORT PA
15132-1623
US

V. Phone/Fax

Practice location:
  • Phone: 724-216-8984
  • Fax:
Mailing address:
  • Phone: 724-216-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier110026265E
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: