Provider Demographics
NPI:1285653600
Name:BELL, BRYONNE C (LCMHC, CADAC)
Entity type:Individual
Prefix:
First Name:BRYONNE
Middle Name:C
Last Name:BELL
Suffix:
Gender:F
Credentials:LCMHC, CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 LOOMIS ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3360
Mailing Address - Country:US
Mailing Address - Phone:802-865-9638
Mailing Address - Fax:
Practice Address - Street 1:177 PEARL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3704
Practice Address - Country:US
Practice Address - Phone:802-660-0580
Practice Address - Fax:802-660-0578
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000390101YA0400X
VT068-0000651101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
11450190OtherCAQH