Healthcare Provider Details

I. General information

NPI: 1720593916
Provider Name (Legal Business Name): CHRISTOPHER LEE BELCHER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2017
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W GRAYSON ST
GALAX VA
24333-2811
US

IV. Provider business mailing address

PO BOX 768
GALAX VA
24333-0768
US

V. Phone/Fax

Practice location:
  • Phone: 276-383-0400
  • Fax: 855-877-4676
Mailing address:
  • Phone: 276-383-0400
  • Fax: 855-877-4676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701007414
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: