Provider Demographics
NPI:1629720131
Name:BELLA MENTE MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:BELLA MENTE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREEZI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE-JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-770-4717
Mailing Address - Street 1:5017 KELSO ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2555
Mailing Address - Country:US
Mailing Address - Phone:757-762-1229
Mailing Address - Fax:
Practice Address - Street 1:739 HIGH ST STE 112
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3425
Practice Address - Country:US
Practice Address - Phone:757-770-4717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty