1730225509 NPI number — MRS. MICHELLE LINDA BELK LCMHC

Table of content: MRS. MICHELLE LINDA BELK LCMHC (NPI 1730225509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730225509 NPI number — MRS. MICHELLE LINDA BELK LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELK
Provider First Name:
MICHELLE
Provider Middle Name:
LINDA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARRISH
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
LINDA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730225509
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 W PARK ST
Provider Second Line Business Mailing Address:
SUITE 213
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03766-1378
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-254-7955
Provider Business Mailing Address Fax Number:
888-974-1161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 W PARK ST
Provider Second Line Business Practice Location Address:
SUITE 213
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03766-1378
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-254-7955
Provider Business Practice Location Address Fax Number:
888-974-1161
Provider Enumeration Date:
01/29/2007

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: 101YM0800X , with the licence number:  708 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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