Provider Demographics
NPI:1588448294
Name:ROTER, BETSY MIKEL (LMHC)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:MIKEL
Last Name:ROTER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-7935
Mailing Address - Country:US
Mailing Address - Phone:917-847-3354
Mailing Address - Fax:
Practice Address - Street 1:56 S WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01835-7935
Practice Address - Country:US
Practice Address - Phone:917-847-3354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health