MEDICARE: MR. EARL J BELL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	KY3009	KY

General Provider Information

NPI Number	:	1720295389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EARL J BELL LCSW

Provider Business Mailing Address
First Line	:	2210 GOLDSMITH LN
Second Line	:	SUITE 109
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-1038
Country	:	US
Telephone Number	:	502-713-2555
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 GOLDSMITH LN
Second Line	:	SUITE 109
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-1038
Country	:	US
Telephone Number	:	502-713-2555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	04/25/2014

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