Individual provider Active NPI

Renee Marie Belisle, LCSW C

  • Clinical Social Worker
  • Laurel, MD
National Provider Identifier
1174699078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
14440 Cherry Lane CT
Suite 218
Laurel, MD 20707
Phone
(301) 490-1011
Fax
(301) 490-1484
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

14440 Cherry Lane CT
Suite 218
Laurel, MD 20707

Mailing address

14440 Cherry Lane CT
Laurel, MD 20904-2358
Phone (301) 490-1011

Other names 1

  • Renee Marie Belisle Colby Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174699078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "209042358",
            "telephone_number": "301-490-1011",
            "fax_number": "301-490-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT",
            "address_2": "SUITE 218",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-490-1011",
            "fax_number": "301-490-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELISLE",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "LCSW C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "BELISLE COLBY",
            "middle_name": "MARIE",
            "credential": "LCSW C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.