Provider Demographics
NPI:1013195817
Name:BELLANTE, TRISH ALAYANA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:TRISH
Middle Name:ALAYANA
Last Name:BELLANTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:ALAYANA
Other - Last Name:WARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MARRIAGE FAMILY THER
Mailing Address - Street 1:104 PILGRIM VILLAGE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9232
Mailing Address - Country:US
Mailing Address - Phone:949-748-0100
Mailing Address - Fax:
Practice Address - Street 1:925 WOODSTOCK RD STE 150
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2208
Practice Address - Country:US
Practice Address - Phone:990-424-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49721106H00000X
GA001465106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist