Individual provider Active NPI

Lisa Marietta Bellecci-St.Romain, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1730412032
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4156 LSCSW Issued in KS
Practice address
221 S. Broadway
Suite 608
Wichita, KS 67202-4213
Phone
(316) 259-3160
Fax
(888) 711-4131
NPI assigned
Sep 18, 2009
Last updated
Aug 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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 4156 LSCSW KS Primary

Addresses

Primary practice location

221 S. Broadway
Suite 608
Wichita, KS 67202-4213

Mailing address

221 S. Broadway
Suite 608
Wichita, KS 67202-4213
Phone (316) 259-3160

Other identifiers 1

IdentifierTypeStateIssuer
200631350AMedicaidKS

Other names 1

  • Lisa Marietta Bellecci Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121128000559 KS Practitioner - Clinical Social Worker 8022260959 Practice locations: Bel Aire, KS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4101 N Edgemoor St
Bel Aire, KS 67220-2033
Phone (316) 259-3160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4156 LSCSWKSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1730412032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S. BROADWAY",
            "address_2": "SUITE 608",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024213",
            "telephone_number": "316-259-3160",
            "fax_number": "888-711-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S. BROADWAY",
            "address_2": "SUITE 608",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024213",
            "telephone_number": "316-259-3160",
            "fax_number": "888-711-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLECCI-ST.ROMAIN",
        "first_name": "LISA",
        "middle_name": "MARIETTA",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-18",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4156 LSCSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200631350A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BELLECCI",
            "middle_name": "MARIETTA",
            "credential": "LSCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.