Healthcare Provider Details

I. General information

NPI: 1720190887
Provider Name (Legal Business Name): STEPHEN PARKS BELL LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEPHEN DEADELUS PARKS

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14415 78TH RD APT 2B
FLUSHING NY
11367-3563
US

IV. Provider business mailing address

144-15 78TH ROAD
FLUSHING NY
11367
US

V. Phone/Fax

Practice location:
  • Phone: 718-591-0177
  • Fax:
Mailing address:
  • Phone: 718-591-0177
  • Fax: 718-845-9380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number00069712
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: