Provider Demographics
NPI:1619366150
Name:BEY, ISIS A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ISIS
Middle Name:A
Last Name:BEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25163
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28229-5163
Mailing Address - Country:US
Mailing Address - Phone:704-469-1243
Mailing Address - Fax:704-469-1713
Practice Address - Street 1:3549 N SHARON AMITY RD STE 203
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-2975
Practice Address - Country:US
Practice Address - Phone:704-469-1243
Practice Address - Fax:704-469-1713
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NCP0089531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty