Provider Demographics
NPI:1508929605
Name:BELLAN ASHNER, REBECCA E (MED, NCC, LPC, CEAP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:E
Last Name:BELLAN ASHNER
Suffix:
Gender:F
Credentials:MED, NCC, LPC, CEAP
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:BELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, NCC, LPC, CEAP
Mailing Address - Street 1:3587 SAN JOSE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-2850
Mailing Address - Country:US
Mailing Address - Phone:314-387-4000
Mailing Address - Fax:800-848-5681
Practice Address - Street 1:14100 MAGELLAN PLZ
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-4644
Practice Address - Country:US
Practice Address - Phone:314-387-4000
Practice Address - Fax:800-848-5681
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional