MEDICARE: MS. ROBIN W BELLANTONE LCMHC

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	564	NH

General Provider Information

NPI Number	:	1619912060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN W BELLANTONE LCMHC

Provider Business Mailing Address
First Line	:	PO BOX 516
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-0516
Country	:	US
Telephone Number	:	603-431-7040
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 BREAKFAST HILL RD
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-2401
Country	:	US
Telephone Number	:	603-431-7040
Fax Number	:

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

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	07/08/2007

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