Provider Demographics
NPI:1003067042
Name:GOEHRING, ANDREA L (LISW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:GOEHRING
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:ROEBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:1555 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2003
Mailing Address - Country:US
Mailing Address - Phone:614-442-0664
Mailing Address - Fax:614-442-0620
Practice Address - Street 1:1555 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2003
Practice Address - Country:US
Practice Address - Phone:614-442-0664
Practice Address - Fax:614-442-0620
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-08001281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical