1336547017 NPI number — MS. KATHLEEN RUTH BELL MED, LMHC, NCC

Table of content: MS. KATHLEEN RUTH BELL MED, LMHC, NCC (NPI 1336547017)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336547017 NPI number — MS. KATHLEEN RUTH BELL MED, LMHC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELL
Provider First Name:
KATHLEEN
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MED, LMHC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLLINS
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
BELL
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MED, LMHC, NCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336547017
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10245 CENTURION PKWY N STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32256-0561
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-674-3521
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10245 CENTURION PKWY N STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32256-0561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-674-3521
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH5612 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com