Individual provider Active NPI

William Louis Bellach III, MA, MSW, LCSW-R

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1407721962
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R049841-01 Issued in NY
Practice address
61 North Ave
Staten Island, NY 10302-2319
Phone
(718) 772-1095
NPI assigned
Oct 6, 2025
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC24334 ME
Clinical Social Worker 1041C0700X R049841-01 NY Primary

Addresses

Primary practice location

61 North Ave
Staten Island, NY 10302-2319

Mailing address

4 Johnson Ter
Middletown, NJ 07748-1734
Phone (718) 772-1095

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LC24334MEMDClinical Social Worker
R049841-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1407721962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 JOHNSON TER",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077481734",
            "telephone_number": "718-772-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 NORTH AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022319",
            "telephone_number": "718-772-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLACH",
        "first_name": "WILLIAM",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MA, MSW, LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC24334",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R049841-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.