Organization
ESSENTIAL ASSESSMENTS AND BEHAVIORAL HEALTH
Active
Organization
ESSENTIAL ASSESSMENTS AND BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVONDA BEAN LPA (PRESIDENT)
(980) 939-5099
Entity
Organization
Contact information
Practice address
9635 SOUTHERN PINE BLVD, SUITE 102, CHARLOTTE, NC 28273-5540
(980) 939-5099
(704) 972-6228
Mailing address
9635 SOUTHERN PINE BLVD, SUITE 102, CHARLOTTE, NC 28273-5540
(980) 939-5099
(704) 972-6228
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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