Healthcare Provider Details

I. General information

NPI: 1609785062
Provider Name (Legal Business Name): MS. JERMAINE DONNELL BELTON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 DANIA DR
FORT WASHINGTON MD
20744-3792
US

IV. Provider business mailing address

1304 DANIA DR
FORT WASHINGTON MD
20744-3792
US

V. Phone/Fax

Practice location:
  • Phone: 202-527-8435
  • Fax:
Mailing address:
  • Phone: 202-527-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: