Healthcare Provider Details

I. General information

NPI: 1508929605
Provider Name (Legal Business Name): REBECCA E BELLAN ASHNER MED, NCC, LPC, CEAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA E BELLAN MED, NCC, LPC, CEAP

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 MAGELLAN PLZ
MARYLAND HEIGHTS MO
63043-4644
US

IV. Provider business mailing address

3587 SAN JOSE LN
SAINT ANN MO
63074-2850
US

V. Phone/Fax

Practice location:
  • Phone: 314-387-4000
  • Fax: 800-848-5681
Mailing address:
  • Phone: 314-387-4000
  • Fax: 800-848-5681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number002564
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: