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General NPI Number Information
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NPI Number | 1700579398
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Entity Type | Organization
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Legal Business Name | BETTENCOURT FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 2 MANOR PKWY STE 2
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City | SALEM
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State | NH
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Zip | 03079-4871
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Country | US
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Telephone | 207-415-9376
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Fax |
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Provider Business Mailing Address
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Address Line | 14 CAYMUS RDG
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City | SALEM
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State | NH
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Zip | 03079-1607
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Country | US
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Telephone | 207-415-9376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON BETTENCOURT
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Credential |
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Telephone | 207-415-9376
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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 |
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License Number State |
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