Provider Demographics
NPI:1093310310
Name:HARTSELL, BELINDA BULLARD
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:BULLARD
Last Name:HARTSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2168 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-1462
Mailing Address - Country:US
Mailing Address - Phone:334-444-8089
Mailing Address - Fax:
Practice Address - Street 1:2208 EXECUTIVE PARK DR # A
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6062
Practice Address - Country:US
Practice Address - Phone:334-329-9930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2303C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health