Provider Demographics
NPI:1619930633
Name:MCCREARY, BETH KIRSTEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:KIRSTEN
Last Name:MCCREARY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:TUROFF
Other - Last Name:MCCREARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:6797 N HIGH ST STE 214
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2533
Mailing Address - Country:US
Mailing Address - Phone:614-436-5030
Mailing Address - Fax:614-436-4830
Practice Address - Street 1:6797 N HIGH ST STE 214
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2533
Practice Address - Country:US
Practice Address - Phone:614-436-5030
Practice Address - Fax:614-436-4830
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5851103TC0700X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2338652Medicaid
OHMCCP28891Medicare PIN