Basic Information
Provider Information
NPI: 1417235813
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BESECE
FirstName: WENDY
MiddleName: ROSE
NamePrefix:  
NameSuffix:  
Credential: MSW, LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 107 PLAZA DR
Address2:  
City: SAINT CLAIRSVILLE
State: OH
PostalCode: 439508786
CountryCode: US
TelephoneNumber: 7405260204
FaxNumber: 7405260207
Practice Location
Address1: 107 PLAZA DR
Address2:  
City: SAINT CLAIRSVILLE
State: OH
PostalCode: 439508786
CountryCode: US
TelephoneNumber: 7405260204
FaxNumber: 7405260207
Other Information
ProviderEnumerationDate: 08/02/2011
LastUpdateDate: 08/02/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000XS0700196OHY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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