Provider Demographics
NPI:1902504848
Name:BELEW, GRACE MARIE (ASW)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:MARIE
Last Name:BELEW
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8538 VILLA LA JOLLA DR APT 174
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8313
Mailing Address - Country:US
Mailing Address - Phone:734-216-6158
Mailing Address - Fax:
Practice Address - Street 1:8538 VILLA LA JOLLA DR APT 174
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-8313
Practice Address - Country:US
Practice Address - Phone:734-216-6158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1134821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical