Provider Demographics
NPI:1497817423
Name:BELLARDO, SHIRLEY (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:BELLARDO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5304
Mailing Address - Country:US
Mailing Address - Phone:609-393-1626
Mailing Address - Fax:609-393-3113
Practice Address - Street 1:946 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5304
Practice Address - Country:US
Practice Address - Phone:609-393-1626
Practice Address - Fax:609-393-3113
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046640001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical