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NPI Code Detail

MEDICARE: DR. ANDREA BEVAN, PSYCHOLOGY, PLLC

MEDICARE: DR. ANDREA BEVAN, PSYCHOLOGY, PLLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1518567155
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. ANDREA BEVAN, PSYCHOLOGY, PLLC
Provider Business Mailing Address
First Line : 2518 ANTHEM VILLAGE DR STE 103
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5554
Country : US
Telephone Number : 702-551-4847
Fax Number :
Provider Business Practice Location Address
First Line : 2518 ANTHEM VILLAGE DR STE 103
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5554
Country : US
Telephone Number : 702-551-4847
Fax Number :
Authorized Official
Title or Position : LICENSED PSYCHOLOGIST
Name : DR. ANDREA BEVAN
Credential : PHD
Telephone Number : 702-551-4847
Provider Enumeration Date : 10/30/2020
Last Update Date : 10/30/2020

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