Albert John Bellg, PH.D. – Clinical Psychologist

Key facts

NPI: 1821048943
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: 2382-057 (WI)
Practice address: 1620 S Lawe St
Appleton, WI 54915-2400
Phone: (920) 996-0887
Fax: (920) 799-4714
NPI assigned: May 11, 2006
Sex: Male
Sole proprietor: Yes

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.

Lifepath, LLC Psychologist · Appleton, WI · NPI 1407172299

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Philosophy

State licenses

License	State	Type	Specialty
2382-057	WI	MD	Clinical Psychologist

Practice roles

Organization	Specialty	Status	New patients
Lifepath, LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Psychologist	103TC0700X	2382-057	WI	Yes

Addresses

Primary practice location

1620 S Lawe St
Appleton, WI 54915-2400

Mailing address

1620 S Lawe St
Appleton, WI 54915-2400
Phone (920) 996-0887

Other identifiers

Identifier	Type	State	Issuer
39136800	Medicaid	WI

Other providers in Appleton, WI

All providers in Appleton, WI · Clinical Psychologist in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.