Healthcare Provider Details

I. General information

NPI: 1326911926
Provider Name (Legal Business Name): BELLA MARCUM LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAHALEY AVE
SALISBURY NC
28144-2448
US

IV. Provider business mailing address

1132 AUTUMN LN
NEW LONDON NC
28127-8730
US

V. Phone/Fax

Practice location:
  • Phone: 704-636-5522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: