Provider Demographics
NPI:1932218997
Name:ANDES, BETH ANN (PCC)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:ANDES
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47863 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8479
Mailing Address - Country:US
Mailing Address - Phone:740-695-3630
Mailing Address - Fax:740-695-3631
Practice Address - Street 1:47863 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8479
Practice Address - Country:US
Practice Address - Phone:740-695-3630
Practice Address - Fax:740-695-3631
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001713054OtherMOUNTAIN STATE BCBS
OH278713000OtherMAGELLAN HEALTH SERVICES
PA418532OtherCOMMUNITY CARE BEHAVIORAL HEALTH ORGANIZATION
7205001OtherAETNA
469571OtherVALUE OPTIONS
OHY570312AOtherHEALTH PLAN OF THE UPPER