Provider Demographics
NPI: | 1053752972 |
---|---|
Name: | CHANTHAPASEUTH, BETSY (LCSW) |
Entity type: | Individual |
Prefix: | |
First Name: | BETSY |
Middle Name: | |
Last Name: | CHANTHAPASEUTH |
Suffix: | |
Gender: | F |
Credentials: | LCSW |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1290 CHAMBERS RD |
Mailing Address - Street 2: | |
Mailing Address - City: | AURORA |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80011-7117 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-617-2300 |
Mailing Address - Fax: | 303-617-2344 |
Practice Address - Street 1: | 14301 E HAMPDEN AVE |
Practice Address - Street 2: | |
Practice Address - City: | AURORA |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80014-3902 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-617-2300 |
Practice Address - Fax: | 303-617-2344 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2013-07-08 |
Last Update Date: | 2025-04-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101YM0800X, 225400000X | ||
CO | 09925745 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |