Provider Demographics
NPI:1548239924
Name:VANESS, BELINDA MAE (MBS LPC NCC)
Entity type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:MAE
Last Name:VANESS
Suffix:
Gender:F
Credentials:MBS LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 CHICKASAW RD
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:OK
Mailing Address - Zip Code:74730-4501
Mailing Address - Country:US
Mailing Address - Phone:580-230-9127
Mailing Address - Fax:
Practice Address - Street 1:2402 W MORTON ST
Practice Address - Street 2:SUITE D2
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1402
Practice Address - Country:US
Practice Address - Phone:580-230-9127
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6574LCMedicare UPIN