Provider Demographics
NPI:1538272083
Name:BELLER, KAREN R (MS, LPE)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:BELLER
Suffix:
Gender:F
Credentials:MS, LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 SUN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-2685
Mailing Address - Country:US
Mailing Address - Phone:870-612-3618
Mailing Address - Fax:
Practice Address - Street 1:500 E MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-4663
Practice Address - Country:US
Practice Address - Phone:870-569-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR97-16EI103TS0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool