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NPI Code Detail

MEDICARE: DR. SHANA MARIE BELLOW PH.D.

MEDICARE: DR. SHANA MARIE BELLOW PH.D.
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
1103T00000XPsychologist0810005286VA
2103TC2200XClinical Child & Adolescent PsychologistPSY1000415DC

General Provider Information

NPI Number : 1780825497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANA MARIE BELLOW PH.D.
Provider Business Mailing Address
First Line : PO BOX 37174
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3174
Country : US
Telephone Number : 571-423-5699
Fax Number : 571-423-5698
Provider Business Practice Location Address
First Line : 2800 S SHIRLINGTON RD STE 706
Second Line :
City : ARLINGTON
State : VA
Zip : 22206-3602
Country : US
Telephone Number : 571-777-2350
Fax Number : 571-777-2331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2009
Last Update Date : 04/17/2026

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