Provider Demographics
NPI:1427115872
Name:DARROW, BETH A (MS LPC)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:A
Last Name:DARROW
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:A
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS LPCC
Mailing Address - Street 1:6457 VOOSCANE AVE
Mailing Address - Street 2:
Mailing Address - City:COCHITI LAKE
Mailing Address - State:NM
Mailing Address - Zip Code:87083-6001
Mailing Address - Country:US
Mailing Address - Phone:903-316-1678
Mailing Address - Fax:
Practice Address - Street 1:3212 MONTE VISTA BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2120
Practice Address - Country:US
Practice Address - Phone:903-315-1678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12904101YP2500X
NMCCNH0177881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM06109802Medicaid