Provider Demographics
NPI:1649724642
Name:HARBORSIDE WELLBEING, PLLC
Entity type:Organization
Organization Name:HARBORSIDE WELLBEING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:TAUBER
Authorized Official - Last Name:PRIOR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-940-1822
Mailing Address - Street 1:17505 W CATAWBA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8065
Mailing Address - Country:US
Mailing Address - Phone:704-940-1822
Mailing Address - Fax:
Practice Address - Street 1:17505 W CATAWBA AVE STE 100
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8065
Practice Address - Country:US
Practice Address - Phone:704-940-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty