Active NPI
Teres Betts, MS
- Mental Health Occupational Therapist
- New Haven, CT
National Provider Identifier
1497482236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Occupational Therapist
- License
- 004105
- Practice address
- 419 Whalley Avenue
1St Floor Suite 101
New Haven, CT 06511 - Phone
- (203) 439-5555
- Fax
- (203) 738-1117
- NPI assigned
- Aug 2, 2022
- Last updated
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | 004105 | CT | Primary |
Addresses
Primary practice location
419 Whalley Avenue
1St Floor Suite 101
New Haven, CT 06511
Mailing address
419 Whalley Avenue
1St Floor Suite 101
New Haven, CT 06511
Phone (203) 439-5555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306401377 | Medicaid | CT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | RELIANTBEHAVIORALHEALTHCS@GMAIL.COM | Health Information Exchange (HIE) |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004105 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1497482236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 WHALLEY AVENUE",
"address_2": "1ST FLOOR SUITE 101",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06511",
"telephone_number": "203-439-5555",
"fax_number": "203-738-1117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 WHALLEY AVENUE",
"address_2": "1ST FLOOR SUITE 101",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06511",
"telephone_number": "203-439-5555",
"fax_number": "203-738-1117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETTS",
"first_name": "TERES",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "CT",
"license": "004105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306401377",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "RELIANTBEHAVIORALHEALTHCS@GMAIL.COM",
"affiliation": "N",
"endpointDescription": "BUSINESS EMAIL",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "EMPLOYER EMAIL",
"address_1": "419 WHALLEY AVENUE",
"address_2": "1ST FLOOR SUITE 101",
"city": "New Haven",
"state": "CT",
"country_code": "US",
"postal_code": "06511",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.