Provider Demographics
NPI:1407941222
Name:BELL, ANDREA MARIE (PCC, LICDC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:BELL
Suffix:
Gender:F
Credentials:PCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 STIRLING WAY
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7109
Mailing Address - Country:US
Mailing Address - Phone:330-990-5468
Mailing Address - Fax:
Practice Address - Street 1:7610 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3126
Practice Address - Country:US
Practice Address - Phone:614-626-2696
Practice Address - Fax:866-820-4098
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health