Provider Demographics
NPI:1861585135
Name:BELSON, ELAINE SARAH (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:SARAH
Last Name:BELSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 HAMPSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:PORT TOBACCO
Mailing Address - State:MD
Mailing Address - Zip Code:20677-3427
Mailing Address - Country:US
Mailing Address - Phone:301-751-9972
Mailing Address - Fax:301-392-9806
Practice Address - Street 1:6225 HAMPSTEAD CT
Practice Address - Street 2:
Practice Address - City:PORT TOBACCO
Practice Address - State:MD
Practice Address - Zip Code:20677-3427
Practice Address - Country:US
Practice Address - Phone:301-751-9972
Practice Address - Fax:301-392-9806
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQE53ESMedicare UPIN
MD096876Medicare UPIN
MD263883Medicare UPIN
MD906QMedicare ID - Type Unspecified
MD565371Medicare UPIN
MD222455Medicare UPIN