Healthcare Provider Details
I. General information
NPI: 1730225509
Provider Name (Legal Business Name): MICHELLE LINDA BELK LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 W PARK ST SUITE 213
LEBANON NH
03766-1378
US
IV. Provider business mailing address
20 W PARK ST SUITE 213
LEBANON NH
03766-1378
US
V. Phone/Fax
- Phone: 508-254-7955
- Fax: 888-974-1161
- Phone: 508-254-7955
- Fax: 888-974-1161
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 708 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: