Provider Demographics
NPI:1124155304
Name:NEWBERN, BETTE NANETTE (MED LPC)
Entity type:Individual
Prefix:MRS
First Name:BETTE
Middle Name:NANETTE
Last Name:NEWBERN
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 SCENIC VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-9155
Mailing Address - Country:US
Mailing Address - Phone:830-257-7942
Mailing Address - Fax:
Practice Address - Street 1:842 SIDNEY BAKER ST STE D
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3366
Practice Address - Country:US
Practice Address - Phone:830-329-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12261101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional