Healthcare Provider Details

I. General information

NPI: 1407136492
Provider Name (Legal Business Name): IAN ANDREW BELMONT -HARDWICK LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 NW MEDICAL LOOP SUITE E
ROSEBURG OR
97471
US

IV. Provider business mailing address

272 NW MEDICAL LOOP SUITE E
ROSEBURG OR
97471
US

V. Phone/Fax

Practice location:
  • Phone: 541-900-4285
  • Fax: 888-810-2993
Mailing address:
  • Phone: 541-900-4285
  • Fax: 888-810-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: