Provider Demographics
NPI:1750430153
Name:TIERNEY, BETH ANNE (MS, MA)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:TIERNEY
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANNE
Other - Last Name:D'AGOSTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 CHITTENDEN RD
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3309
Mailing Address - Country:US
Mailing Address - Phone:781-545-3106
Mailing Address - Fax:
Practice Address - Street 1:460 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-8130
Practice Address - Country:US
Practice Address - Phone:617-774-6036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor