Organization
MCB BEHAVIORAL HEALTH, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANA BELVEDERE PH.D. (CLINICAL PSYCHOLOGIST)
(859) 426-7800
Entity
Organization
Contact information
Practice address
503 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 426-7800
(859) 426-7804
Mailing address
503 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 426-7800
(859) 426-7804
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
KY-1304
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343674
ANTHEM BEHAVIORAL HEALTH
KY
01
—
11585564
CAQH
KY
05
—
89000863
—
KY
Enumeration date
08/05/2007
Last updated
08/05/2007
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