Provider Demographics
NPI:1316297831
Name:JAY, BETSY (MDIV; MS)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:JAY
Suffix:
Gender:F
Credentials:MDIV; MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 MAIN ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2527
Mailing Address - Country:US
Mailing Address - Phone:607-431-1030
Mailing Address - Fax:607-431-1033
Practice Address - Street 1:242 MAIN ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2527
Practice Address - Country:US
Practice Address - Phone:607-431-1030
Practice Address - Fax:607-431-1033
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor