Provider Demographics
NPI:1831829530
Name:BELLIZZI, SAMANTHA JOAN (LCSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JOAN
Last Name:BELLIZZI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:JOAN
Other - Last Name:VANRIPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:690 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-4402
Mailing Address - Country:US
Mailing Address - Phone:774-253-9413
Mailing Address - Fax:
Practice Address - Street 1:690 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-4402
Practice Address - Country:US
Practice Address - Phone:774-253-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical