Basic Information
| Provider Information | |||||||||
| NPI: | 1811174568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELCHER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | B. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCPC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2336 GODDARD PKWY | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218011126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346961 | ||||||||
| FaxNumber: | 4103346362 | ||||||||
| Practice Location | |||||||||
| Address1: | 2336 GODDARD PKWY | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218011126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346961 | ||||||||
| FaxNumber: | 4103346362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2008 | ||||||||
| LastUpdateDate: | 06/01/2015 | ||||||||
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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 | 101YM0800X | 495 | NH | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | LC6385 | MD | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 259147-000 | 01 | MD | MAGELLAN | OTHER | 520202700 | 05 | MD | MEDICAID | 609550001 | 05 | MD | MEDICAID | LM49EA | 01 | MD | CAREFIRST BCBS OF MD | OTHER | R968 | 01 | MD | CAREFIRST | OTHER | 2153120 | 01 | NH | CIGNA | OTHER | 30423605 | 05 | NH | MEDICAID | 517251 | 01 | MD | OPTUM | OTHER | 14Y001542NH02 | 01 | NH | BLUE CROSS BLUE SHIELD | OTHER | 522156095 | 01 | ME | COMMERCIAL INSURANCE | OTHER | 7840093 | 01 | MD | AETNA | OTHER |