Individual
RUSSELL STEVEN BELLAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
3358 S 2ND ST STE A-C, CABOT, AR 72023-7873
(501) 286-6053
(501) 286-6090
Mailing address
2809 FOREST HOME RD, JONESBORO, AR 72401-5320
(866) 972-1268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A1706220
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259512795
—
AR
Enumeration date
06/21/2013
Last updated
04/14/2023
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