Provider Demographics
NPI:1013935956
Name:TIBBETTS-WILLIAMS, BETH ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:BETH ANN
Middle Name:
Last Name:TIBBETTS-WILLIAMS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-3202
Mailing Address - Country:US
Mailing Address - Phone:216-459-9827
Mailing Address - Fax:216-696-5638
Practice Address - Street 1:5255 N ABBE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1451
Practice Address - Country:US
Practice Address - Phone:440-934-9930
Practice Address - Fax:440-934-9645
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000319295OtherANTHEM BLUE CROSS PIN