Healthcare Provider Details

I. General information

NPI: 1023796976
Provider Name (Legal Business Name): MS. LEIA CHEYANNE BELLINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20225 BOTHELL EVERETT HWY APT 813
BOTHELL WA
98012-8183
US

IV. Provider business mailing address

20225 BOTHELL EVERETT HWY APT 813
BOTHELL WA
98012-8183
US

V. Phone/Fax

Practice location:
  • Phone: 904-562-0780
  • Fax:
Mailing address:
  • Phone: 904-562-0780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMHC.LH.70059590
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: