Provider Demographics
NPI:1477955839
Name:BELLEVUE COUNSELING LLC
Entity Type:Organization
Organization Name:BELLEVUE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELORE
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-835-0392
Mailing Address - Street 1:174 BELLEVUE AVE
Mailing Address - Street 2:SUITE 306-B
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-3990
Mailing Address - Country:US
Mailing Address - Phone:401-835-0392
Mailing Address - Fax:401-846-1811
Practice Address - Street 1:174 BELLEVUE AVE
Practice Address - Street 2:SUITE 306-B
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3990
Practice Address - Country:US
Practice Address - Phone:401-835-0392
Practice Address - Fax:401-846-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00526101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty