Bean, Shavonda Latiea

Bean, Shavonda Latiea is an sole proprietor health care provider with primary practice located at 8430 University Exec Park Dr Suite 655, Charlotte NC 28262-1350. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Bean, Shavonda Latiea can be contacted via phone (704) 596-5553.

Contact Information

Primary practice address
8430 University Exec Park Dr Suite 655 Charlotte NC 28262-1350
Phone: (704) 596-5553
Fax: (704) 596-1556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2477 North Carolina

Profile Details

NPI number 1770573990
LBN Legal business name Bean, Shavonda Latiea
Credentials MA, LPA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2005
Last updated Apr 25th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770573990 NPPES
North Carolina Other 2118431 CIGNA
North Carolina Other E4167-B0775 CIGNA
North Carolina Other 046KT CIGNA
North Carolina MEDICAID 6107067 CIGNA

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