Provider Demographics
NPI:1932252996
Name:BELCHER, TERENCE LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:LYNN
Last Name:BELCHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-2301
Mailing Address - Country:US
Mailing Address - Phone:508-252-6865
Mailing Address - Fax:
Practice Address - Street 1:55 MAPLE LN
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-2301
Practice Address - Country:US
Practice Address - Phone:508-252-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2927103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAEDCM322OtherPSYCHOLOGIST MASSHEALTH
MA0514322Medicaid
MA0514322Medicaid