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General NPI Number Information
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NPI Number | 1093356859
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Entity Type | Individual
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Provider Name | BETCHIE CLAIRE CORNELIO LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 276 5TH AVE RM 704
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City | NEW YORK
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State | NY
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Zip | 10001-4527
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Country | US
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Telephone | 330-356-8315
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Fax |
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Provider Business Mailing Address
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Address Line | 276 5TH AVE RM 704
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City | NEW YORK
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State | NY
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Zip | 10001-4527
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Country | US
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Telephone | 330-356-8315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 011301
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License Number State | NY
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