Provider Demographics
NPI:1679200901
Name:BELMONT, ELISE (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:BELMONT
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 FALLCREEK CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4940
Mailing Address - Country:US
Mailing Address - Phone:910-274-3605
Mailing Address - Fax:
Practice Address - Street 1:1518 FALLCREEK CT
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4940
Practice Address - Country:US
Practice Address - Phone:910-274-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional