Provider Demographics
NPI:1518976505
Name:BELESS, CLAYTON WAYNE (MSW)
Entity Type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:WAYNE
Last Name:BELESS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675
Mailing Address - Country:US
Mailing Address - Phone:508-362-9304
Mailing Address - Fax:508-775-1245
Practice Address - Street 1:1019 ROUTE 132
Practice Address - Street 2:CHILD & FAMILY SERVICES
Practice Address - City:HYARNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-778-1839
Practice Address - Fax:508-775-1245
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102227101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health