Provider Demographics
NPI:1942417514
Name:BELLER, MARSHA R (LCSW)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:R
Last Name:BELLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1890 DIXWELL AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-3122
Mailing Address - Country:US
Mailing Address - Phone:203-407-6444
Mailing Address - Fax:203-407-6442
Practice Address - Street 1:378 BOSTON POST RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3523
Practice Address - Country:US
Practice Address - Phone:203-799-0138
Practice Address - Fax:203-795-2727
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0015051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical