Provider Demographics
NPI:1518190768
Name:BELLO, CARL E (MA)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:E
Last Name:BELLO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 SEVIER HEIGHTS ROAD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:336-405-8005
Mailing Address - Fax:
Practice Address - Street 1:3602 SEVIER HEIGHTS ROAD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:425-260-0540
Practice Address - Fax:425-349-7256
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-8139101YM0800X
WAVT00008214174M00000X
TN5520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174M00000XOther Service ProvidersVeterinarian