Provider Demographics
NPI:1285825984
Name:BELLINGER, STEPHEN (LCS11511)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:BELLINGER
Suffix:
Gender:M
Credentials:LCS11511
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-4121
Mailing Address - Country:US
Mailing Address - Phone:951-929-2744
Mailing Address - Fax:
Practice Address - Street 1:102 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-4121
Practice Address - Country:US
Practice Address - Phone:951-929-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical