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General NPI Number Information
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NPI Number | 1750998134
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Entity Type | Individual
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Provider Name | DEBRA E. BELACK MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 4076 MARKET ST STE 100
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City | CAMP HILL
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State | PA
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Zip | 17011-4200
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Country | US
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Telephone | 717-918-4900
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Fax | 866-241-2670
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Provider Business Mailing Address
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Address Line | 55 ORCHARD RD
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-9242
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Country | US
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Telephone | 717-395-4923
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Fax | 866-241-2670
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC009544
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC009544
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License Number State | PA
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