Provider Demographics
NPI:1639536311
Name:BELTON, GEORGE (LISW-CP)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:BELTON
Suffix:
Gender:M
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 VALLEY FORGE DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3565
Mailing Address - Country:US
Mailing Address - Phone:615-305-6319
Mailing Address - Fax:
Practice Address - Street 1:125 COMMONWEALTH DR
Practice Address - Street 2:SUITE 390
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4812
Practice Address - Country:US
Practice Address - Phone:864-313-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC112101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical