Healthcare Provider Details

I. General information

NPI: 1124962931
Provider Name (Legal Business Name): GABRIELLA BELLITTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10724 CARMEL COMMONS BLVD STE 540
CHARLOTTE NC
28226-3999
US

IV. Provider business mailing address

6721 IRONKETTLE RD
CHARLOTTE NC
28270-0805
US

V. Phone/Fax

Practice location:
  • Phone: 704-750-1602
  • Fax:
Mailing address:
  • Phone: 704-771-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6993
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: