=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982140851
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHRYN BELMORE LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2017
-----------------------------------------------------
Last Update Date | 09/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PMB 226, 1225 PROVIDENCE ROAD
-----------------------------------------------------
City | WHITINSVILLE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01588-1464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-348-7941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PMB 226, 1225 PROVIDENCE ROAD
-----------------------------------------------------
City | WHITINSVILLE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01588-1464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-348-7941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 12410
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------