Provider Demographics
NPI:1285760579
Name:BEECH, WENDY DIANE (MED, LPC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:DIANE
Last Name:BEECH
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:DIANE
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2515 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1957
Mailing Address - Country:US
Mailing Address - Phone:740-423-4225
Mailing Address - Fax:740-423-4228
Practice Address - Street 1:3194 CORE RD
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1556
Practice Address - Country:US
Practice Address - Phone:304-485-5185
Practice Address - Fax:304-485-0051
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0501074101YP2500X
OHOHI-50-2033 JK3G122101YS0200X
WV2091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001888560Medicare UPIN