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ELIZABETH A. BELLMEN, MA, MHC, AT Washington License No. LH00009896 18223 102nd Avenue NE, Suite A Bothell, WA 98011 4254067373CONFIDENTIAL CLIENT INTAKE FORM Date (Please print)Client ID # Patient
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Bellmer ma lmhc at stands for Massachusetts Licensed Mental Health Counselor Application form.
Individuals seeking to become licensed mental health counselors in Massachusetts are required to file bellmer ma lmhc at.
Bellmer ma lmhc at can be filled out by providing accurate and detailed information about the applicant's education, training, and work experience in the field of mental health counseling.
The purpose of bellmer ma lmhc at is to evaluate the qualifications and competence of individuals applying for licensure as mental health counselors in Massachusetts.
Information such as educational background, clinical experience, supervision hours, and any disciplinary actions taken against the applicant must be reported on bellmer ma lmhc at.
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