Provider Demographics
NPI:1245319524
Name:ATCHISON, BELINDA MCCONNELL
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:MCCONNELL
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19643 HEIGHTS CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-9470
Mailing Address - Country:US
Mailing Address - Phone:231-679-0304
Mailing Address - Fax:
Practice Address - Street 1:10495 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-8740
Practice Address - Country:US
Practice Address - Phone:412-879-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-01407101YA0400X
MI6401010806101YP2500X
MI6301011028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical