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General NPI Number Information
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NPI Number | 1457171167
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Entity Type | Individual
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Provider Name | KATLYNN BELLOTTI LPC-A
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Gender | Female
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 1188 STONECREST BLVD STE 110
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City | FORT MILL
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State | SC
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Zip | 29708-6633
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Country | US
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Telephone | 803-233-3236
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Fax | 803-233-3236
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Provider Business Mailing Address
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Address Line | 1188 STONECREST BLVD STE 110
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City | FORT MILL
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State | SC
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Zip | 29708-6633
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Country | US
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Telephone | 803-233-3236
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Fax | 803-233-3236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | COU.10163
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License Number State | SC
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