Provider Demographics
NPI:1447388111
Name:BELLUCCI, GALE ANN (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:GALE ANN
Middle Name:
Last Name:BELLUCCI
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 RITCHIE HWY STE 308
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3089
Mailing Address - Country:US
Mailing Address - Phone:410-766-9772
Mailing Address - Fax:410-766-9774
Practice Address - Street 1:7310 RITCHIE HWY STE 308
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3089
Practice Address - Country:US
Practice Address - Phone:410-766-9772
Practice Address - Fax:410-766-9774
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD070251041C0700X
MA10180091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028783OtherVALUEOPTIONS
MDPVPB122063OtherAPS HEALTHCARE
CA028783OtherVALUEOPTIONS
MDQU10GA27OtherMAGELLAN
MD218809OtherMAPSI
TX028783OtherVALUEOPTIONS
CA096609OtherMANAGED HEALTH NETWORK
MD218809OtherMAMSI
DCT1740001OtherBCBS OF NATIONAL CAPITAL
MD52537205OtherCAREFIRST BCBS
MD218809OtherOPTIMUM CHOICE
MDT1740001OtherCAREFIRST BLUECHOICE
MD4527759OtherAETNA PROVIDER ID
VAQU10GA27OtherNCAS
MD218809OtherONENET PROVIDER ID
MD218809OtherMDIPA
MDQU10GA27OtherBCBS PROVIDER ID
MDT1740001OtherCAREFIRST BLUEPREFERRED
MDQU10Medicare ID - Type Unspecified