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General NPI Number Information
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NPI Number | 1043829724
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Entity Type | Organization
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Legal Business Name | BLUE BELL BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 230 E CIVIC CENTER DR APT 2035
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City | GILBERT
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State | AZ
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Zip | 85296-0101
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Country | US
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Telephone | 520-463-3911
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Fax |
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Provider Business Mailing Address
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Address Line | 230 E CIVIC CENTER DR APT 2035
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City | GILBERT
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State | AZ
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Zip | 85296-0101
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Country | US
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Telephone | 152-046-3391
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE MANAGER
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Name | MISS LISA TAPIA
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Credential | LAMFT
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Telephone | 520-463-3911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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