Healthcare Provider Details

I. General information

NPI: 1831854561
Provider Name (Legal Business Name): SHANNA BEEBE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 EAGLE CREST DR NE
GRAND RAPIDS MI
49525-7005
US

IV. Provider business mailing address

1437 HILLCREST AVE NW
GRAND RAPIDS MI
49504-2630
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-8745
  • Fax:
Mailing address:
  • Phone: 810-394-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451019787
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: