Provider Demographics
NPI:1720756208
Name:BEVAN, SHELIA (LPC)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:BEVAN
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 1:10777 BARKLEY ST STE 120
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1162
Mailing Address - Country:US
Mailing Address - Phone:913-204-0582
Mailing Address - Fax:
Practice Address - Street 1:10777 BARKLEY ST STE 120
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1162
Practice Address - Country:US
Practice Address - Phone:913-204-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS3790OtherSTATE LIC.