Leah Bellack, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW110236 Issued in CA

Practice address

376 Center Street
Chula Vista, CA 91910

Phone

(619) 365-5855

NPI assigned

Sep 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Evolution Psychotherapy, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1356779482
  NPD (past)

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1083264659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 UNIVERSITY AVE # 1070",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033312",
            "telephone_number": "619-365-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 CENTER STREET",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-365-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLACK",
        "first_name": "LEAH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW89480",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW110236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angellen Belardo
• Nezer Bartolome Belen, FNP-C
• Bruce Bell, D.C., Q.M.E.
• Emily Bell
• Susan Marie Bell, LCSW
• Bellahomecare LLC
• Bellahomecare LLC
• Bellahomecare LLC
• Lani W Bellegarde, LPCC, MFT
• Fernando Bello

• Clinical Social Worker in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.