Provider Demographics
NPI:1831688902
Name:BELCH, ROGERS BOND
Entity type:Individual
Prefix:
First Name:ROGERS
Middle Name:BOND
Last Name:BELCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 YOUNGS FARM RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-1535
Mailing Address - Country:US
Mailing Address - Phone:410-280-2333
Mailing Address - Fax:410-280-9866
Practice Address - Street 1:1419 FOREST DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-1482
Practice Address - Country:US
Practice Address - Phone:410-280-2333
Practice Address - Fax:410-280-2333
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD226241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical