Provider Demographics
NPI:1215302542
Name:BELLAMY, SHEILA (MS)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:MUHWEZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 54723
Mailing Address - Street 2:C/O FLCES
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-4723
Mailing Address - Country:US
Mailing Address - Phone:904-239-3677
Mailing Address - Fax:904-239-3278
Practice Address - Street 1:6950 PHILIPS HWY
Practice Address - Street 2:SUITE 11
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6074
Practice Address - Country:US
Practice Address - Phone:904-239-3677
Practice Address - Fax:904-239-3278
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2111106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist