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General NPI Number Information
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NPI Number | 1598149940
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Entity Type | Organization
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Legal Business Name | BEL CENTERLLC
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 130 AUSTINE DR
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7040
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Country | US
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Telephone | 802-451-0189
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Fax |
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Provider Business Mailing Address
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Address Line | 212 FOX FARM RD
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City | BRATTLEBORO
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State | VT
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Zip | 05301-9135
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Country | US
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Telephone | 802-451-0180
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Fax |
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Authorized Official
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Title or Position | EXECTUTIVE DIRECTOR
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Name | MR. JAMES OLSON
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Credential | BCBA, LCMHC
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Telephone | 802-451-0180
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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 | 068-0000656
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 00000000000000
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License Number State | VT
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