=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942384375
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRACY S BELL LPCC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 10/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1532 LONE OAK RD STE 345
-----------------------------------------------------
City | PADUCAH
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42003-7942
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-444-2250
-----------------------------------------------------
Fax | 270-538-6596
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1532 LONE OAK RD STE 345
-----------------------------------------------------
City | PADUCAH
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42003-7942
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-444-2250
-----------------------------------------------------
Fax | 270-538-6596
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 239609
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------