Provider Demographics
NPI:1346133519
Name:BELLEFY, MICHAELA (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:BELLEFY
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:
Other - Last Name:ANTTILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 19TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-2541
Mailing Address - Country:US
Mailing Address - Phone:701-308-1767
Mailing Address - Fax:
Practice Address - Street 1:9245 QUANTRELLE AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-0168
Practice Address - Country:US
Practice Address - Phone:763-746-9492
Practice Address - Fax:763-746-3685
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN318131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical