Healthcare Provider Details

I. General information

NPI: 1801053665
Provider Name (Legal Business Name): RUTH ELIZABETH BELL ED.M; LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BEACON ST
BROOKLINE MA
02446-4816
US

IV. Provider business mailing address

1415 BEACON ST
BROOKLINE MA
02446-4816
US

V. Phone/Fax

Practice location:
  • Phone: 617-401-4364
  • Fax: 617-383-6210
Mailing address:
  • Phone: 617-401-4364
  • Fax: 617-383-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119194
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: