Organization
PEDIATRIC AND FAMILY BEHAVIORAL HEALTH, PLLC
Active
Other names
Oasis Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
LISBETH IVELISSE LEGER DE BETANCOURT (OFFICE MANAGER)
(704) 764-1818
Entity
Organization
Contact information
Practice address
1111 CIRCLE DR, MONROE, NC 28112-5834
(704) 764-1818
(704) 285-2222
Mailing address
1111 CIRCLE DR, MONROE, NC 28112-5834
(704) 764-1818
(704) 285-2222
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2012-01513
NC
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700385507
NPI
NC
Enumeration date
02/07/2018
Last updated
06/08/2021
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