Provider Demographics
NPI:1922842095
Name:BELLE, STARKISHA NICOLE (CADCII, MATS, CCS,)
Entity type:Individual
Prefix:
First Name:STARKISHA
Middle Name:NICOLE
Last Name:BELLE
Suffix:
Gender:F
Credentials:CADCII, MATS, CCS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:GA
Mailing Address - Zip Code:31626-0195
Mailing Address - Country:US
Mailing Address - Phone:229-289-2252
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 195
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:GA
Practice Address - Zip Code:31626-0195
Practice Address - Country:US
Practice Address - Phone:229-289-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA104101YP2500X
GA0533101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional