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General NPI Number Information
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NPI Number | 1649465741
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Entity Type | Individual
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Provider Name | MAYA SOPHIA BELITSKI PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | PO BOX 9169 W. STATE STREET #2427
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City | GARDEN CITY
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State | ID
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Zip | 83714
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Country | US
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Telephone | 310-869-1549
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Fax |
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Provider Business Mailing Address
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Address Line | 16 LINCOLN ST STE C
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City | BRUNSWICK
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State | ME
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Zip | 04011-1900
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Country | US
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Telephone | 603-883-0005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY30848
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS2611
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License Number State | ME
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