Individual provider Active NPI

Jessica Leigh Bellucci, LCSW-C

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1871024224
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17208 Issued in MD
Practice address
240 S Potomac St
Suite 201a
Hagerstown, MD 21740-6005
Phone
(301) 733-2431
Fax
(301) 733-2432
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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 17208 MD Primary

Addresses

Primary practice location

240 S Potomac St
Suite 201a
Hagerstown, MD 21740-6005

Mailing address

5 W Main St
Apartment 1
Middletown, MD 21769-8068
Phone (301) 676-8656

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
17208MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1871024224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W MAIN ST",
            "address_2": "APARTMENT 1",
            "city": "MIDDLETOWN",
            "state": "MD",
            "postal_code": "217698068",
            "telephone_number": "301-676-8656",
            "fax_number": "301-733-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S POTOMAC ST",
            "address_2": "SUITE 201A",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406005",
            "telephone_number": "301-733-2431",
            "fax_number": "301-733-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLUCCI",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.