MEDICARE: JESSICA M BELL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC06123900	NJ
2	101YM0800X	Mental Health Counselor	SW135805	PA

General Provider Information

NPI Number	:	1114521549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA M BELL LCSW

Provider Business Mailing Address
First Line	:	25 S CHURCH RD UNIT 52
Second Line	:
City	:	MAPLE SHADE
State	:	NJ
Zip	:	08052-3057
Country	:	US
Telephone Number	:	302-228-5884
Fax Number	:

Provider Business Practice Location Address
First Line	:	2518 SALMON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-4011
Country	:	US
Telephone Number	:	302-228-5884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	11/29/2023

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Directions to “ JESSICA M BELL LCSW” Practice Location

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