MEDICARE: JESSICA RENEE BELK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904006627	VA

General Provider Information

NPI Number	:	1073708053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RENEE BELK LCSW

Provider Business Mailing Address
First Line	:	13454 NAYLORS BLUE DR
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2908
Country	:	US
Telephone Number	:	804-243-5159
Fax Number	:

Provider Business Practice Location Address
First Line	:	2663 OSBORNE RD STE 1
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-2168
Country	:	US
Telephone Number	:	804-243-5159
Fax Number	:	804-597-0240

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	04/17/2024

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