Provider Demographics
NPI:1316010234
Name:BESSANT, EDWARD EUGENE (LPC)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:EUGENE
Last Name:BESSANT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 88011
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-8011
Mailing Address - Country:US
Mailing Address - Phone:910-574-2575
Mailing Address - Fax:910-868-1196
Practice Address - Street 1:4989 ROCKFISH RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-8355
Practice Address - Country:US
Practice Address - Phone:910-829-1824
Practice Address - Fax:910-868-1196
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2857101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102061Medicaid