Provider Demographics
NPI:1194382069
Name:JESSE BELLE COUNSELING PLLC
Entity Type:Organization
Organization Name:JESSE BELLE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-708-5919
Mailing Address - Street 1:1639 N ALPINE RD STE 403
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1440
Mailing Address - Country:US
Mailing Address - Phone:815-708-5919
Mailing Address - Fax:815-229-7108
Practice Address - Street 1:1639 N ALPINE RD STE 403
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-1440
Practice Address - Country:US
Practice Address - Phone:815-708-5919
Practice Address - Fax:815-229-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)