Provider Demographics
NPI:1285991604
Name:BETZ, MAUREEN C (LICSW)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:C
Last Name:BETZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 GOOD HOPE RD SE
Mailing Address - Street 2:OFFICE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4777
Mailing Address - Country:US
Mailing Address - Phone:202-292-4460
Mailing Address - Fax:202-889-8491
Practice Address - Street 1:71 O ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1258
Practice Address - Country:US
Practice Address - Phone:202-292-4460
Practice Address - Fax:202-889-8491
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500790431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical