Provider Demographics
NPI:1780018028
Name:BELTRAMO PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:BELTRAMO PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:SINDEN
Authorized Official - Last Name:BELTRAMO
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPA
Authorized Official - Phone:310-699-2060
Mailing Address - Street 1:107 HOLLY BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9402
Mailing Address - Country:US
Mailing Address - Phone:310-699-2060
Mailing Address - Fax:
Practice Address - Street 1:107 HOLLY BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9402
Practice Address - Country:US
Practice Address - Phone:310-699-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4449103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty