1508929605 NPI number — MRS. REBECCA E BELLAN ASHNER MED, NCC, LPC, CEAP

Table of content: MRS. REBECCA E BELLAN ASHNER MED, NCC, LPC, CEAP (NPI 1508929605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508929605 NPI number — MRS. REBECCA E BELLAN ASHNER MED, NCC, LPC, CEAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELLAN ASHNER
Provider First Name:
REBECCA
Provider Middle Name:
E
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MED, NCC, LPC, CEAP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BELLAN
Provider Other First Name:
REBECCA
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MED, NCC, LPC, CEAP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508929605
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3587 SAN JOSE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT ANN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63074-2850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-387-4000
Provider Business Mailing Address Fax Number:
800-848-5681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14100 MAGELLAN PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARYLAND HEIGHTS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63043-4644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-387-4000
Provider Business Practice Location Address Fax Number:
800-848-5681
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  002564 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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