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General NPI Number Information
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NPI Number | 1346895554
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Entity Type | Individual
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Provider Name | JACOBY BELL LMSW
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Gender | Male
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 305 W MOODY ST
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City | POPLARVILLE
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State | MS
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Zip | 39470-7338
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Country | US
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Telephone | 601-240-2024
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Fax |
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Provider Business Mailing Address
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Address Line | 520 N 38TH AVE APT 3
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City | HATTIESBURG
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State | MS
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Zip | 39401-5733
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Country | US
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Telephone | 601-447-8680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | M9556
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License Number State | MS
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