1811174568 NPI number — MR. WILLIAM B. BELCHER LCPC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811174568 NPI number — MR. WILLIAM B. BELCHER LCPC

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BELCHER

Provider First Name:

WILLIAM

Provider Middle Name:

B.

Provider Name Prefix Text:

MR.

Provider Name Suffix Text:

Provider Credential Text:

LCPC

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1811174568

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/01/2015

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2336 GODDARD PKWY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SALISBURY

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21801-1126

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-334-6961

Provider Business Mailing Address Fax Number:

410-334-6362

Provider First Line Business Practice Location Address:

2336 GODDARD PKWY

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SALISBURY

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21801-1126

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-334-6961

Provider Business Practice Location Address Fax Number:

410-334-6362

Provider Enumeration Date:

01/24/2008

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 101YM0800X , with the licence number:  495 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 101YP2500X , with the licence number: LC6385 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 259147-000 . This is a "MAGELLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 520202700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 609550001 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: LM49EA . This is a "CAREFIRST BCBS OF MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: R968 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 2153120 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 30423605 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
• Identifier: 517251 . This is a "OPTUM" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 14Y001542NH02 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 522156095 . This is a "COMMERCIAL INSURANCE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
• Identifier: 7840093 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".