Provider Demographics
NPI:1891178661
Name:BELLAMY, VERONDA (MS, LCAS-A, LPCA,)
Entity type:Individual
Prefix:MRS
First Name:VERONDA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:MS, LCAS-A, LPCA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 RIVERWOOD PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-6002
Mailing Address - Country:US
Mailing Address - Phone:704-222-2928
Mailing Address - Fax:866-331-1114
Practice Address - Street 1:3050 RIVERWOOD PKWY STE B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-6002
Practice Address - Country:US
Practice Address - Phone:704-671-9617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21380101YA0400X
NCA13870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467729855OtherHEALTH INSURANCE
NC1467729855Medicaid