Individual provider Active NPI

Lisa M Bellamy, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1477066579
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006704A Issued in IN
Practice address
6314 Rucker Rd Ste a
Indianapolis, IN 46220-4800
Phone
(317) 514-5805
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

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
34006704AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
All Things to All People Community Service Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34006704A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

6314 Rucker Rd Ste a
Indianapolis, IN 46220-4800

Mailing address

6314 Rucker Rd Ste a
Indianapolis, IN 46220-4800
Phone (317) 514-5805

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
201319690AMedicaidIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2025.

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1477066579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 RUCKER RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204800",
            "telephone_number": "317-514-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 RUCKER RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204800",
            "telephone_number": "317-514-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAMY",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006704A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201319690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.