Provider Demographics
NPI:1831517986
Name:MCNIERNEY, BETH (BSL)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MCNIERNEY
Suffix:
Gender:F
Credentials:BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 STOCKTON RDG
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-2261
Mailing Address - Country:US
Mailing Address - Phone:724-612-7135
Mailing Address - Fax:412-661-1867
Practice Address - Street 1:5648 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3610
Practice Address - Country:US
Practice Address - Phone:412-661-1827
Practice Address - Fax:412-661-1867
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000246103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100754254OtherMEDICAL ASSISTANCE