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General NPI Number Information
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NPI Number | 1881208221
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Entity Type | Individual
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Provider Name | KATHRYN KIKI BELLAS LMSW, MFA
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Gender | Female
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 80 5TH AVE RM 903
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City | NEW YORK
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State | NY
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Zip | 10011-7611
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Country | US
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Telephone | 212-633-9162
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Fax |
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Provider Business Mailing Address
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Address Line | 812 8TH AVE APT 1C
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City | BROOKLYN
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State | NY
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Zip | 11215-4122
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Country | US
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Telephone | 646-320-9704
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110119
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License Number State | NY
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