Provider Demographics
NPI:1215218904
Name:BELLEW, RENEE MICHELLE (LICSW PIP)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MICHELLE
Last Name:BELLEW
Suffix:
Gender:F
Credentials:LICSW PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 7TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ATTALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35954-2048
Mailing Address - Country:US
Mailing Address - Phone:256-295-7402
Mailing Address - Fax:
Practice Address - Street 1:306 7TH AVE NW
Practice Address - Street 2:
Practice Address - City:ATTALLA
Practice Address - State:AL
Practice Address - Zip Code:35954-2048
Practice Address - Country:US
Practice Address - Phone:256-344-5155
Practice Address - Fax:256-344-5155
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1273-3856C101YM0800X, 1041C0700X
AL3078G101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1962945600OtherTYPE 2 NPI