# PEDIATRIC AND FAMILY BEHAVIORAL HEALTH, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oasis Behavioral Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700385507
- **Authorized official:** LISBETH IVELISSE LEGER DE BETANCOURT (OFFICE MANAGER)
- **Authorized official phone:** (704) 764-1818

## Contact information

- **Practice address:** 1111 CIRCLE DR, MONROE, NC 28112-5834
- **Practice address phone:** (704) 764-1818
- **Practice address fax:** (704) 285-2222
- **Mailing address:** 1111 CIRCLE DR, MONROE, NC 28112-5834
- **Mailing address phone:** (704) 764-1818
- **Mailing address fax:** (704) 285-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 2012-01513 | NC | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/07/2018
- **Last updated:** 06/08/2021