Active NPI
Ivette Betancourt, LPC
- Marriage & Family Therapist
- Wethersfield, CT
National Provider Identifier
1093908576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001711
- Practice address
- 433 Silas Deane Hwy
Wethersfield, CT 06109-2123 - Phone
- (860) 881-9856
- NPI assigned
- Aug 20, 2007
- Last updated
- Jan 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001711 | CT | Primary |
Addresses
Primary practice location
433 Silas Deane Hwy
Wethersfield, CT 06109-2123
Mailing address
76 Judd Rd
Wethersfield, CT 06109-1135
Phone (860) 881-9856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001711 | CT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421366400000",
"number": "1093908576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 JUDD RD",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061091135",
"telephone_number": "860-881-9856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 SILAS DEANE HWY",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061092123",
"telephone_number": "860-881-9856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETANCOURT",
"first_name": "IVETTE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2015-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wethersfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.