Provider Demographics
NPI:1972198190
Name:BESS, HEATHER (LISW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BESS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 STONE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-3108
Mailing Address - Country:US
Mailing Address - Phone:931-551-6895
Mailing Address - Fax:
Practice Address - Street 1:8787 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-6809
Practice Address - Country:US
Practice Address - Phone:216-973-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.21026361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical