Provider Demographics
NPI:1053753525
Name:FRUITMAN, BELINA (LCSW, CACLLL)
Entity type:Individual
Prefix:MRS
First Name:BELINA
Middle Name:
Last Name:FRUITMAN
Suffix:
Gender:F
Credentials:LCSW, CACLLL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8751 E HAMPDEN AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4929
Mailing Address - Country:US
Mailing Address - Phone:303-523-0621
Mailing Address - Fax:
Practice Address - Street 1:8751 E HAMPDEN AVE STE B2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4929
Practice Address - Country:US
Practice Address - Phone:303-523-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
CO9919361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)