Provider Demographics
NPI:1871024224
Name:BELLUCCI, JESSICA LEIGH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH
Last Name:BELLUCCI
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Gender:F
Credentials:LCSW-C
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Mailing Address - Street 1:5 W MAIN ST
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-8068
Mailing Address - Country:US
Mailing Address - Phone:301-676-8656
Mailing Address - Fax:301-733-2432
Practice Address - Street 1:240 S POTOMAC ST
Practice Address - Street 2:SUITE 201A
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6005
Practice Address - Country:US
Practice Address - Phone:301-733-2431
Practice Address - Fax:301-733-2432
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2021-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD172081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical