Provider Demographics
NPI:1699781773
Name:BELMONT, YOLANDA R (LCSW)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:R
Last Name:BELMONT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:R
Other - Last Name:BOBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:303 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-7204
Mailing Address - Country:US
Mailing Address - Phone:203-624-8532
Mailing Address - Fax:203-439-0889
Practice Address - Street 1:303 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-7204
Practice Address - Country:US
Practice Address - Phone:203-624-8532
Practice Address - Fax:203-439-0889
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0012961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001296OtherCT STATE LICENSE