| Doctor Name: | SHANTRA BEANE |
| NPI Number: | 1063634442 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, LCAS |
| License Number: | 4302 |
| Business Practice Address: | 3821 Forrestgate Dr Dba Forsyth Behavior Health Winston Salem, NC - 271032930 |
| Business Phone Number: | 3362771811 |
| Business Fax Number: | |
| Mailing Address: | 5807 Harvest Springs Drive, GREENSBORO |
| State: | NC |
| Postal Code: | 274068045 |
| Phone Number: | 3369634517 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 09/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 4302 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |