Provider Demographics
NPI:1467502013
Name:BELLER, GLORIA MYERS (LICSW LICENSED INDEP)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:MYERS
Last Name:BELLER
Suffix:
Gender:F
Credentials:LICSW LICENSED INDEP
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:S
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1238 WISCONSIN AVE NW
Mailing Address - Street 2:# 401
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-625-7696
Mailing Address - Fax:202-625-7696
Practice Address - Street 1:1238 WISCONSIN AVE NW
Practice Address - Street 2:# 401
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3248
Practice Address - Country:US
Practice Address - Phone:202-625-7696
Practice Address - Fax:202-625-7696
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3015801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical