Provider Demographics
NPI:1144430497
Name:BELVITCH, PAUL VINCENT (MA, LMHC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:VINCENT
Last Name:BELVITCH
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 ADMINISTRATION ST
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-9668
Mailing Address - Country:US
Mailing Address - Phone:941-766-9196
Mailing Address - Fax:941-766-7103
Practice Address - Street 1:3400 TAMIAMI TRL
Practice Address - Street 2:SUITE 204
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8102
Practice Address - Country:US
Practice Address - Phone:941-629-0440
Practice Address - Fax:941-766-7103
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH#5059OtherSTATE LICENSE