Healthcare Provider Details

I. General information

NPI: 1184257644
Provider Name (Legal Business Name): DALLEN RAY BELL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 JOHN ADAMS PKWY
IDAHO FALLS ID
83401-4072
US

IV. Provider business mailing address

1434 N 615 E
SHELLEY ID
83274-5077
US

V. Phone/Fax

Practice location:
  • Phone: 208-557-8593
  • Fax: 208-243-8428
Mailing address:
  • Phone: 208-557-8593
  • Fax: 208-243-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-43320
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: