Provider Demographics
NPI:1306103973
Name:BEAMAN, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 STONEGATE S
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-7310
Mailing Address - Country:US
Mailing Address - Phone:765-491-4989
Mailing Address - Fax:
Practice Address - Street 1:1613 STONEGATE S
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-7310
Practice Address - Country:US
Practice Address - Phone:765-491-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst