Basic Information
| Provider Information | |||||||||
| NPI: | 1679036818 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELCHER | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LSW, BSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 N 3RD ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430555550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403497511 | ||||||||
| FaxNumber: | 7404144050 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 N 3RD ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430555550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403497511 | ||||||||
| FaxNumber: | 7404144050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2019 | ||||||||
| LastUpdateDate: | 04/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.