Provider Demographics
NPI:1891871323
Name:BEGAY, BETTIE A (LMSW)
Entity type:Individual
Prefix:
First Name:BETTIE
Middle Name:A
Last Name:BEGAY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OLD WEST MESA #12
Mailing Address - Street 2:
Mailing Address - City:CROWNPOINT
Mailing Address - State:NM
Mailing Address - Zip Code:87313
Mailing Address - Country:US
Mailing Address - Phone:928-729-8513
Mailing Address - Fax:928-729-8530
Practice Address - Street 1:CORNER OF RT N12 AND N7
Practice Address - Street 2:
Practice Address - City:FORT DEFIANC
Practice Address - State:AZ
Practice Address - Zip Code:86504
Practice Address - Country:US
Practice Address - Phone:928-729-8513
Practice Address - Fax:928-729-8530
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-1911104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker