Provider Demographics
NPI:1336179571
Name:WELLNITZ, BELINDA B (CSAC, LPC, MS)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:B
Last Name:WELLNITZ
Suffix:
Gender:F
Credentials:CSAC, LPC, MS
Other - Prefix:
Other - First Name:BELINDA
Other - Middle Name:B
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:903 MINERAL POINT AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2970
Mailing Address - Country:US
Mailing Address - Phone:608-756-6530
Mailing Address - Fax:608-741-6918
Practice Address - Street 1:903 MINERAL POINT AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2970
Practice Address - Country:US
Practice Address - Phone:608-756-6530
Practice Address - Fax:608-741-6918
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15716-132101YA0400X
WI3469-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1336179571OtherDEANHEALTH PLAN
WI1336179571OtherBCBSWI
WI1336179571Medicaid
WIWELLNBELOtherMERCYCARE INSURANCE