Provider Demographics
NPI:1447528716
Name:BELT, CAROLINE CONNELLY (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CONNELLY
Last Name:BELT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:RYCYNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 LAFAYETTE RD # 326
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2451
Mailing Address - Country:US
Mailing Address - Phone:978-419-2741
Mailing Address - Fax:
Practice Address - Street 1:45 LAFAYETTE RD # 326
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2451
Practice Address - Country:US
Practice Address - Phone:978-419-2741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1238831041C0700X
NH21771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicaid