Healthcare Provider Details

I. General information

NPI: 1891423174
Provider Name (Legal Business Name): JULIES A BELL SUD COUNSELOR 1
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14515 HAMLIN ST
VAN NUYS CA
91411-1686
US

IV. Provider business mailing address

14515 HAMLIN ST
VAN NUYS CA
91411-1686
US

V. Phone/Fax

Practice location:
  • Phone: 818-285-1900
  • Fax: 818-285-1906
Mailing address:
  • Phone: 818-285-1900
  • Fax: 818-285-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCI49421025
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: