Provider Demographics
NPI:1760963748
Name:BELSON, PETER S (LICSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:S
Last Name:BELSON
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 BEALS ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6010
Mailing Address - Country:US
Mailing Address - Phone:617-320-1290
Mailing Address - Fax:617-232-1941
Practice Address - Street 1:91 BEALS ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6010
Practice Address - Country:US
Practice Address - Phone:617-320-1290
Practice Address - Fax:617-232-1941
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104722-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical