MEDICARE: ESSENTIAL ASSESSMENTS AND BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	103TB0200X	Cognitive & Behavioral Psychologist
3	103TC2200X	Clinical Child & Adolescent Psychologist
4	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1568849446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL ASSESSMENTS AND BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	9635 SOUTHERN PINE BLVD
Second Line	:	SUITE 102
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5540
Country	:	US
Telephone Number	:	980-939-5099
Fax Number	:	704-972-6228

Provider Business Practice Location Address
First Line	:	9635 SOUTHERN PINE BLVD
Second Line	:	SUITE 102
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5540
Country	:	US
Telephone Number	:	980-939-5099
Fax Number	:	704-972-6228

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHAVONDA BEAN
Credential	:	LPA
Telephone Number	:	980-939-5099

Provider Enumeration Date	:	04/30/2015
Last Update Date	:	04/30/2015

Similar Medicare Providers

1407244718 — KRISTIN N. DAVIS LMFT
Practice Location Address:

9635 SOUTHERN PINE BLVD , STE 101
CHARLOTTE, NC
28273-5540

Practice Phone: 704-266-0651
Practice Fax:

1952782013 — TENDER LOVING CARE HOME HEALTH CARE
Practice Location Address:

9635 SOUTHERN PINE BLVD , SUITE # 136
CHARLOTTE, NC
28273-5540

Practice Phone: 704-578-8833
Practice Fax:

1699218875 — MS. TRACY CHAVONNE SETZER LCSWA
Practice Location Address:

9635 SOUTHERN PINE BLVD
CHARLOTTE, NC
28273-5540

Practice Phone: 704-491-3097
Practice Fax: 704-625-7120

1528593753 — SOLUTIONS FOR LIFE; COUNSELING, LIFE COACHING, AND CONSULTING SERVICES
Practice Location Address:

9635 SOUTHERN PINE BLVD , SUITE 122,124
CHARLOTTE, NC
28273-5540

Practice Phone: 704-649-9078
Practice Fax:

1619576311 — FREEDOM NOW HOME CARE-NC, LLC
Practice Location Address:

9635 SOUTHERN PINE BLVD OFC PARK
CHARLOTTE, NC
28273-5540

Practice Phone: 980-221-1273
Practice Fax:

1205799954 — THE COMPRESSIONIST, INC.
Practice Location Address:

218 WESTINGHOUSE BLVD STE 207
CHARLOTTE, NC
28273-6242

Practice Phone: 980-445-5600
Practice Fax:

Directions to “ESSENTIAL ASSESSMENTS AND BEHAVIORAL HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.