Provider Demographics
NPI:1043079965
Name:MBEYU, SOPHY RIZIKI
Entity Type:Individual
Prefix:
First Name:SOPHY
Middle Name:RIZIKI
Last Name:MBEYU
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 1:3209 ARKLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0998
Mailing Address - Country:US
Mailing Address - Phone:704-817-9910
Mailing Address - Fax:
Practice Address - Street 1:3209 ARKLOW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0998
Practice Address - Country:US
Practice Address - Phone:704-817-9910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TH0100X, 104100000X, 251E00000X, 251K00000X, 376K00000X
NC372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No376K00000XNursing Service Related ProvidersNurse's Aide