Healthcare Provider Details

I. General information

NPI: 1437228475
Provider Name (Legal Business Name): CARA BELVISO CAMPANELLA LPC,LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 E WATERFORD WAY
HENRICO VA
23233-1648
US

IV. Provider business mailing address

508 LIBBIE AVE STE 100
RICHMOND VA
23226-2618
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-1800
  • Fax:
Mailing address:
  • Phone: 804-282-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0717000237
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001624
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: