Provider Demographics
NPI:1083390710
Name:BELIZAIRE, ABIMAELLE (LMSW)
Entity type:Individual
Prefix:
First Name:ABIMAELLE
Middle Name:
Last Name:BELIZAIRE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 DANBY RD STE 202F
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5714
Mailing Address - Country:US
Mailing Address - Phone:607-260-3100
Mailing Address - Fax:
Practice Address - Street 1:950 DANBY RD STE 202F
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5714
Practice Address - Country:US
Practice Address - Phone:607-260-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121718101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor