Provider Demographics
NPI:1285286104
Name:BELLAMY, LISA MICHELLE (MHC)
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:MICHELLE
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 ROCKAWAY PKWY APT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3227
Mailing Address - Country:US
Mailing Address - Phone:929-385-1018
Mailing Address - Fax:
Practice Address - Street 1:426 ROCKAWAY PKWY APT 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3227
Practice Address - Country:US
Practice Address - Phone:929-385-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY012051101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health