Provider Demographics
NPI:1043829724
Name:BLUE BELL BEHAVIORAL HEALTH PLLC
Entity type:Organization
Organization Name:BLUE BELL BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:LAMFT
Authorized Official - Phone:520-463-3911
Mailing Address - Street 1:230 E CIVIC CENTER DR APT 2035
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-0101
Mailing Address - Country:US
Mailing Address - Phone:152-046-3391
Mailing Address - Fax:
Practice Address - Street 1:230 E CIVIC CENTER DR APT 2035
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-0101
Practice Address - Country:US
Practice Address - Phone:520-463-3911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health