Provider Demographics
NPI:1871816322
Name:BEHZAD, SHABNAM (LPC)
Entity Type:Individual
Prefix:
First Name:SHABNAM
Middle Name:
Last Name:BEHZAD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 1/2 EAST LOUISIANA STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069
Mailing Address - Country:US
Mailing Address - Phone:214-620-0859
Mailing Address - Fax:
Practice Address - Street 1:114 1/2 EAST LOUISIANA STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069
Practice Address - Country:US
Practice Address - Phone:214-620-0859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional