Healthcare Provider Details

I. General information

NPI: 1225877913
Provider Name (Legal Business Name): MATHIAS ORION BELL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 3RD ST
FORT POLK LA
71459-5102
US

IV. Provider business mailing address

1585 3RD ST
FORT POLK LA
71459-5102
US

V. Phone/Fax

Practice location:
  • Phone: 726-780-2175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119166
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: