Individual provider Active NPI

Ivan Jermaine Belin, MA

  • Counselor
  • Chesterfield, SC
National Provider Identifier
1962685164
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
207 Commerce Ave
Chesterfield, SC 29709-0471
Phone
(843) 623-2229
Fax
(843) 623-2559
NPI assigned
Dec 11, 2007
Last updated
Dec 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

207 Commerce Ave
Chesterfield, SC 29709-0471

Mailing address

PO Box 471
207 Commerce Ave
Chesterfield, SC 29709-0471
Phone (843) 623-2229

Other identifiers 1

IdentifierTypeStateIssuer
405127MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1962685164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 471",
            "address_2": "207 COMMERCE AVE",
            "city": "CHESTERFIELD",
            "state": "SC",
            "postal_code": "297090471",
            "telephone_number": "843-623-2229",
            "fax_number": "843-623-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 COMMERCE AVE",
            "city": "CHESTERFIELD",
            "state": "SC",
            "postal_code": "297090471",
            "telephone_number": "843-623-2229",
            "fax_number": "843-623-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELIN",
        "first_name": "IVAN",
        "middle_name": "JERMAINE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405127",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.