Provider Demographics
NPI:1750758090
Name:BELOUCHI, TERESA MAY (LISW-S)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MAY
Last Name:BELOUCHI
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:MAY
Other - Last Name:ESTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:161 WYNDCREST CT APT A
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1791
Mailing Address - Country:US
Mailing Address - Phone:513-693-3318
Mailing Address - Fax:
Practice Address - Street 1:161 WYNDCREST CT APT A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1791
Practice Address - Country:US
Practice Address - Phone:513-360-8857
Practice Address - Fax:513-712-2699
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1801312-SUPR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical