Healthcare Provider Details

I. General information

NPI: 1881250165
Provider Name (Legal Business Name): EMILY BELL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 BELMONT DR
DOTHAN AL
36305-6500
US

IV. Provider business mailing address

187 BELMONT DR
DOTHAN AL
36305-6500
US

V. Phone/Fax

Practice location:
  • Phone: 334-671-1280
  • Fax: 334-671-0475
Mailing address:
  • Phone: 334-671-1280
  • Fax: 334-671-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier102I802476
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerMEDICARE
# 2
Identifier240208
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer

VIII. Authorized Official

Name: MRS. EMILY BELL
Title or Position: OWNER
Credential: LICSW, PIP
Phone: 334-671-1280