Healthcare Provider Details

I. General information

NPI: 1821234881
Provider Name (Legal Business Name): PHYLLIS LOUISE BELL MS, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PHYLLIS L BELL MS, LPC, NCC

II. Dates (important events)

Enumeration Date: 12/22/2008
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 650
HASKELL OK
74436-8741
US

IV. Provider business mailing address

RR 1 BOX 650
HASKELL OK
74436-8741
US

V. Phone/Fax

Practice location:
  • Phone: 918-671-6131
  • Fax: 918-482-1709
Mailing address:
  • Phone: 918-671-6131
  • Fax: 918-482-1709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1672
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1821234881
Identifier TypeOTHER
Identifier StateOK
Identifier IssuerTRICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: