Provider Demographics
NPI:1679073670
Name:COY, BETSY J
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:J
Last Name:COY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10216B CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-9411
Mailing Address - Country:US
Mailing Address - Phone:330-305-9100
Mailing Address - Fax:330-305-9103
Practice Address - Street 1:10216B CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9411
Practice Address - Country:US
Practice Address - Phone:330-305-9100
Practice Address - Fax:330-305-9103
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901475101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0233251Medicaid
OH0376547Medicaid
OH78797000OtherOHIO ID