Provider Demographics
NPI:1609306364
Name:BELLIFEMINE, GINA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:BELLIFEMINE
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 MAIDA TER
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6267
Mailing Address - Country:US
Mailing Address - Phone:732-213-8670
Mailing Address - Fax:
Practice Address - Street 1:285 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3005
Practice Address - Country:US
Practice Address - Phone:908-295-9852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06277800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker