Healthcare Provider Details

I. General information

NPI: 1598077166
Provider Name (Legal Business Name): CARLA BELSHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARLA DELLAMORE

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 PROFESSIONAL PLZ
ASHBURN VA
20147-7783
US

IV. Provider business mailing address

12004 BERRY FARM CT
OAK HILL VA
20171-1627
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-9446
  • Fax:
Mailing address:
  • Phone: 650-793-5546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: