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Provider Information for 1396382743


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LEQUOIA RENE BELL-PERSON LMHC


Sex: Female

NPI: 1396382743
Last Updated: 2023-10-24
Certification Date: 2023-10-23

Details

NameValue
NPI1396382743
Enumeration Date2019-12-04
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1205 MASTERPIECE DR
HOPE MILLS, NC 28348-7518
United States

Phone: | Fax:
 
Primary Practice Address 2817 ROCK MERRITT AVE STOP A
FORT LIBERTY, NC 28310-5827
United States

Phone: 910-907-8707 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental HealthFLIMH17004
Yes 101YM0800X - Counselor - Mental HealthFLMH22228