MEDICARE: MR. CARL E BELLO MA

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
1	101YM0800X	Mental Health Counselor	LCPC-8139	ID
2	174M00000X	Veterinarian	VT00008214	WA
3	101YM0800X	Mental Health Counselor	5520	TN

General Provider Information

NPI Number	:	1518190768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL E BELLO MA

Provider Business Mailing Address
First Line	:	3602 SEVIER HEIGHTS ROAD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920
Country	:	US
Telephone Number	:	336-405-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	3602 SEVIER HEIGHTS ROAD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920
Country	:	US
Telephone Number	:	425-260-0540
Fax Number	:	425-349-7256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	09/15/2023

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