Provider Demographics
NPI:1689345449
Name:BELVIN, KEITH L (MHSC, MS ED)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:L
Last Name:BELVIN
Suffix:
Gender:M
Credentials:MHSC, MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 N DUPONT HWY # 1276
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-2006
Mailing Address - Country:US
Mailing Address - Phone:302-314-3802
Mailing Address - Fax:
Practice Address - Street 1:413 HIGH ST
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3923
Practice Address - Country:US
Practice Address - Phone:302-394-6051
Practice Address - Fax:302-485-5887
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist