Provider Demographics
NPI:1255497038
Name:MCCARTNEY-BELCHER, SUSIE RENEE
Entity Type:Individual
Prefix:MRS
First Name:SUSIE
Middle Name:RENEE
Last Name:MCCARTNEY-BELCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 W CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-2367
Mailing Address - Country:US
Mailing Address - Phone:928-595-1461
Mailing Address - Fax:928-774-2159
Practice Address - Street 1:476 W ROUND VALLEY RD
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-4139
Practice Address - Country:US
Practice Address - Phone:928-595-1461
Practice Address - Fax:928-774-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4563253J00000X, 385HR2055X
AZ253J00000X, 385HR2055X
322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No253J00000XAgenciesFoster Care Agency
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children