Provider Demographics
NPI:1942219357
Name:BELK, STEPHEN T (PSYD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:T
Last Name:BELK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S W S YOUNG DR STE 407
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-3374
Mailing Address - Country:US
Mailing Address - Phone:254-252-3748
Mailing Address - Fax:254-549-0086
Practice Address - Street 1:3800 S W S YOUNG DR STE 407
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3374
Practice Address - Country:US
Practice Address - Phone:254-252-3748
Practice Address - Fax:254-549-0086
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33688103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1942219357Medicaid
MO493437065Medicaid
P00351355OtherRR MEDICARE
MO493437057Medicaid
MO1942219357Medicaid
MO493437057Medicaid