Provider Demographics
NPI:1992806111
Name:BELLVILLE, DAVID CHRISTOPHER (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:BELLVILLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 STANWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2846
Mailing Address - Country:US
Mailing Address - Phone:297-729-8727
Mailing Address - Fax:297-729-8727
Practice Address - Street 1:4 STANWOOD ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2846
Practice Address - Country:US
Practice Address - Phone:297-729-8727
Practice Address - Fax:297-729-8727
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP417101YP1600X
MECC348101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional