Basic Information
| Provider Information | |||||||||
| NPI: | 1457604985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STILES | ||||||||
| FirstName: | BELINDA | ||||||||
| MiddleName: | JOYCE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LISW-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 441 E 8TH ST | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458042482 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192213072 | ||||||||
| FaxNumber: | 4192258878 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NEW CARLISLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453441835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9376671122 | ||||||||
| FaxNumber: | 4192258878 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2012 | ||||||||
| LastUpdateDate: | 03/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 149.013952 | IL | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | I1000007 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 0091868 | 05 | OH | MEDICAID |