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NPI Code Detail

MEDICARE: KATLYNN BELLOTTI LPC-A

MEDICARE: KATLYNN BELLOTTI LPC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistCOU.10163SC

General Provider Information

NPI Number : 1457171167
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATLYNN BELLOTTI LPC-A
Provider Business Mailing Address
First Line : 1188 STONECREST BLVD STE 110
Second Line :
City : FORT MILL
State : SC
Zip : 29708-6633
Country : US
Telephone Number : 803-233-3236
Fax Number : 803-233-3236
Provider Business Practice Location Address
First Line : 1188 STONECREST BLVD STE 110
Second Line :
City : FORT MILL
State : SC
Zip : 29708-6633
Country : US
Telephone Number : 803-233-3236
Fax Number : 803-233-3236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2024
Last Update Date : 10/16/2024

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Directions to “ KATLYNN BELLOTTI LPC-A” Practice Location

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