Individual provider Active NPI

Lisa R Bello, LICSW, LADC-I, CEAP

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1013255199
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1032433 Issued in MA
Practice address
1150 Great Plain Ave
Suite 920271
Needham, MA 02492
Phone
(617) 680-7669
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 666 MA
Clinical Social Worker 1041C0700X 1032433 MA Primary

Addresses

Primary practice location

1150 Great Plain Ave
Suite 920271
Needham, MA 02492

Mailing address

PO Box 920271
Needham, MA 02492-0003
Phone (617) 680-7669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1032433MAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1013255199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920271",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024920003",
            "telephone_number": "617-680-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GREAT PLAIN AVE",
            "address_2": "SUITE 920271",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02492",
            "telephone_number": "617-680-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLO",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "LICSW, LADC-I, CEAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "666",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1032433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.