Individual
LISA M BELLAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6314 RUCKER RD STE A, INDIANAPOLIS, IN 46220-4800
(317) 514-5805
Mailing address
6314 RUCKER RD STE A, INDIANAPOLIS, IN 46220-4800
(317) 514-5805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006704A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201319690A
—
IN
Enumeration date
11/10/2017
Last updated
04/01/2025
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