Provider Demographics
NPI:1942018213
Name:DEEMS, ANDY
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:DEEMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E WILSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2345
Mailing Address - Country:US
Mailing Address - Phone:614-515-3000
Mailing Address - Fax:
Practice Address - Street 1:90 E WILSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2345
Practice Address - Country:US
Practice Address - Phone:614-629-9113
Practice Address - Fax:614-629-9120
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH191004101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)