Individual provider Active NPI

Debra Jo Bellm, MSW, LCSW

  • Clinical Social Worker
  • Swansea, IL
National Provider Identifier
1831230846
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013884 Issued in IL
Practice address
6 Emerald Ter Ste 4
Swansea, IL 62226-2312
Phone
(618) 516-3337
NPI assigned
Feb 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 2248277 IL
Clinical Social Worker 1041C0700X 149.013884 IL Primary

Addresses

Primary practice location

6 Emerald Ter Ste 4
Swansea, IL 62226-2312

Mailing address

1609 Arkansas Rd
Highland, IL 62249-4355
Phone (618) 654-3453

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

State licenses

LicenseStateTypeSpecialty
149.013884ILMDClinical Social Worker
2248277ILMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
William a. Victor Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1831230846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 ARKANSAS RD",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622494355",
            "telephone_number": "618-654-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EMERALD TER STE 4",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262312",
            "telephone_number": "618-516-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLM",
        "first_name": "DEBRA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "2248277",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.