Provider Demographics
NPI:1184160178
Name:BELEVICH, KRISTINA (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:BELEVICH
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:BECKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:37 CLEAR LAKE MNR
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06471-1555
Mailing Address - Country:US
Mailing Address - Phone:203-868-1028
Mailing Address - Fax:
Practice Address - Street 1:134 STATE ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-3293
Practice Address - Country:US
Practice Address - Phone:203-237-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0105811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical