Individual
SHANTRA BEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCAS
Contact information
Practice address
3821 FORRESTGATE DR, DBA FORSYTH BEHAVIOR HEALTH, WINSTON SALEM, NC 27103-2930
(336) 277-1811
Mailing address
5807 HARVEST SPRINGS DRIVE, GREENSBORO, NC 27406-8045
(336) 963-4517
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4302
NC
Other
Enumeration date
05/03/2007
Last updated
09/30/2010
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