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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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