Provider Demographics
NPI:1083632608
Name:BELLIZZI, BERNADETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:BELLIZZI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 ELM ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1844
Mailing Address - Country:US
Mailing Address - Phone:860-563-5633
Mailing Address - Fax:860-224-9766
Practice Address - Street 1:1080 ELM ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1844
Practice Address - Country:US
Practice Address - Phone:860-563-5633
Practice Address - Fax:860-224-9766
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0000011101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor