Provider Demographics
NPI:1104134667
Name:PAUL, BETSY ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:ANN
Last Name:PAUL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9832 CRAWFORD FARMS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6600
Mailing Address - Country:US
Mailing Address - Phone:214-316-9923
Mailing Address - Fax:
Practice Address - Street 1:920 ROBERTS CUT OFF RD
Practice Address - Street 2:SUITE A
Practice Address - City:RIVER OAKS
Practice Address - State:TX
Practice Address - Zip Code:76114-2826
Practice Address - Country:US
Practice Address - Phone:817-624-1222
Practice Address - Fax:817-624-1213
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63121101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist