Provider Demographics
NPI:1215355805
Name:BELTON, PAULINE S (LCPC-ACS)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:S
Last Name:BELTON
Suffix:
Gender:F
Credentials:LCPC-ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 LAUREL PARK DR STE 221
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5203
Mailing Address - Country:US
Mailing Address - Phone:240-858-0696
Mailing Address - Fax:240-660-4657
Practice Address - Street 1:14201 LAUREL PARK DR STE 221
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:240-858-0696
Practice Address - Fax:240-660-4657
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC15522101YM0800X
MDLC5222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health