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NPI Code Detail

MEDICARE: VANESSA BELLAMY LPC, NCC

MEDICARE: VANESSA BELLAMY LPC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor1754MS
2101Y00000XCounselor1754MS
3101YM0800XMental Health Counselor1754MS

General Provider Information

NPI Number : 1780976183
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA BELLAMY LPC, NCC
Provider Business Mailing Address
First Line : PO BOX 12395
Second Line :
City : JACKSON
State : MS
Zip : 39236-2395
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 232 MARKET ST
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-3339
Country : US
Telephone Number : 601-500-1194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2011
Last Update Date : 03/30/2015

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