Provider Demographics
NPI:1396079182
Name:BELLE COMMUNITY COUNSELING, LLC
Entity type:Organization
Organization Name:BELLE COMMUNITY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PYD
Authorized Official - Phone:573-859-3744
Mailing Address - Street 1:BOX 326
Mailing Address - Street 2:706 TIBBETTS
Mailing Address - City:BELLE
Mailing Address - State:MO
Mailing Address - Zip Code:65013-0326
Mailing Address - Country:US
Mailing Address - Phone:573-859-3744
Mailing Address - Fax:
Practice Address - Street 1:706 TIBBETTS
Practice Address - Street 2:
Practice Address - City:BELLE
Practice Address - State:MO
Practice Address - Zip Code:65013-0326
Practice Address - Country:US
Practice Address - Phone:573-859-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0500251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1841290236Medicaid