Healthcare Provider Details

I. General information

NPI: 1154718732
Provider Name (Legal Business Name): MARCIA BELLER LPC, NCC, ADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S EISENHOWER DR
BECKLEY WV
25801-4929
US

IV. Provider business mailing address

101 S EISENHOWER DR
BECKLEY WV
25801-4929
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-6783
  • Fax: 304-252-6796
Mailing address:
  • Phone: 304-252-6783
  • Fax: 304-252-6796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1154
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: