Provider Demographics
NPI:1649463902
Name:BELIN-BURNS, DELORES A (LPC)
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:A
Last Name:BELIN-BURNS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 CAMP ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9234
Mailing Address - Country:US
Mailing Address - Phone:843-762-4619
Mailing Address - Fax:
Practice Address - Street 1:1355 CAMP RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9243
Practice Address - Country:US
Practice Address - Phone:843-762-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5542101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC190166Medicaid