Provider Demographics
NPI:1023834611
Name:BELLEW, MELANIE (LMSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BELLEW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 EAST ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-7612
Mailing Address - Country:US
Mailing Address - Phone:903-490-8810
Mailing Address - Fax:
Practice Address - Street 1:148 MILLER COUNTY 484
Practice Address - Street 2:
Practice Address - City:FOUKE
Practice Address - State:AR
Practice Address - Zip Code:71837-9454
Practice Address - Country:US
Practice Address - Phone:903-490-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR26284-M101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health