Provider Demographics
NPI:1881163236
Name:BELA LUZ
Entity type:Organization
Organization Name:BELA LUZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-744-7352
Mailing Address - Street 1:101 ARCH ST FL 8
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-7500
Mailing Address - Country:US
Mailing Address - Phone:617-744-7352
Mailing Address - Fax:
Practice Address - Street 1:101 ARCH ST FL 8
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-7500
Practice Address - Country:US
Practice Address - Phone:617-905-7747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty