Provider Demographics
NPI:1467038547
Name:BEE WELL CHILD AND FAMILY THERAPY
Entity Type:Organization
Organization Name:BEE WELL CHILD AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:563-209-6033
Mailing Address - Street 1:411 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:PORT BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61275-9635
Mailing Address - Country:US
Mailing Address - Phone:563-209-6033
Mailing Address - Fax:
Practice Address - Street 1:736 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5749
Practice Address - Country:US
Practice Address - Phone:563-209-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-20
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health