Provider Demographics
NPI:1164240305
Name:BETTY EASTMAN, LCSW AND ASSOCIATES, INC
Entity type:Organization
Organization Name:BETTY EASTMAN, LCSW AND ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-868-0072
Mailing Address - Street 1:370 WYTHE CREEK RD STE C
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1926
Mailing Address - Country:US
Mailing Address - Phone:757-868-0072
Mailing Address - Fax:757-868-0087
Practice Address - Street 1:370 WYTHE CREEK RD STE C
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1926
Practice Address - Country:US
Practice Address - Phone:757-868-0072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETTY EASTMAN LCSW AND ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty