Provider Demographics
NPI:1215325329
Name:BELICIA, BARBARA JOANNA (OTRL)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOANNA
Last Name:BELICIA
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1835
Mailing Address - Country:US
Mailing Address - Phone:203-636-0065
Mailing Address - Fax:203-399-0006
Practice Address - Street 1:101 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1835
Practice Address - Country:US
Practice Address - Phone:203-636-0065
Practice Address - Fax:203-399-0006
Is Sole Proprietor?:No
Enumeration Date:2014-12-26
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004280225XE0001X, 225XP0019X, 225XN1300X, 225X00000X, 225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT068560OtherUHC
CT1284635OtherANTHEM
CT1200590OtherAETNA
CT20005664OtherHARVARD
CT3812947OtherWELLCARE
CT8078938Medicaid
CT1284635OtherCIGNA
CT1158567OtherCONNECTICARE
CT068560OtherMEDRISK