Basic Information
| Provider Information | |||||||||
| NPI: | 1659804151 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELFORTI | ||||||||
| FirstName: | LOREN | ||||||||
| MiddleName: | ELISSA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 BABCOCK ST | ||||||||
| Address2: | TRIANGLE PROGRAM | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024466773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177313200 | ||||||||
| FaxNumber: | 6175660894 | ||||||||
| Practice Location | |||||||||
| Address1: | 227 BABCOCK ST | ||||||||
| Address2: | TRIANGLE PROGRAM | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024466773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177313200 | ||||||||
| FaxNumber: | 6175660894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2017 | ||||||||
| LastUpdateDate: | 04/11/2017 | ||||||||
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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 | 221467 | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.