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General NPI Number Information
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NPI Number | 1336086768
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Entity Type | Individual
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Provider Name | JACOB MICHAEL BELLAMY LLC
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Gender | Male
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 120 S MAIN ST STE C
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City | MILFORD
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State | MI
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Zip | 48381-1975
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Country | US
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Telephone | 248-529-6383
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Fax |
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Provider Business Mailing Address
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Address Line | 2790 PATRICK HENRY ST APT 703
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City | AUBURN HILLS
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State | MI
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Zip | 48326-2262
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | MI
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