Healthcare Provider Details

I. General information

NPI: 1073554093
Provider Name (Legal Business Name): SUSAN BELL YORK L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. SUSAN HARRIS BELL

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LAKESIDE DRIVE
SNEADS FERRY NC
28460
US

IV. Provider business mailing address

132 DRAKE ROAD
HAMPSTEAD NC
28443
US

V. Phone/Fax

Practice location:
  • Phone: 910-512-6985
  • Fax: 910-270-4546
Mailing address:
  • Phone: 910-512-6985
  • Fax: 910-270-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberC000476
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC000476
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: