Provider Demographics
NPI:1982844056
Name:BELLUCCI, JOSEPH THOMAS (EDD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:BELLUCCI
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:7 HETLER DRIVE
Mailing Address - City:CONYNGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:18219-0055
Mailing Address - Country:US
Mailing Address - Phone:570-788-3341
Mailing Address - Fax:
Practice Address - Street 1:7 HETLER DRIVE
Practice Address - Street 2:
Practice Address - City:CONYNGHAM
Practice Address - State:PA
Practice Address - Zip Code:18219
Practice Address - Country:US
Practice Address - Phone:570-788-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS000680L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health