MEDICARE: MATTHEW TODD BELL PSY.D.

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	103TC0700X	Clinical Psychologist	1280	LA

General Provider Information

NPI Number	:	1255312716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW TODD BELL PSY.D.

Provider Business Mailing Address
First Line	:	USA MEDDAC; ATTN: CREDENTIALS
Second Line	:	11505 MT BELEVEDERE BLVD
City	:	FT. DRUM
State	:	NY
Zip	:	13602-5004
Country	:	US
Telephone Number	:	315-772-4025
Fax Number	:	315-772-9498

Provider Business Practice Location Address
First Line	:	USA MEDDAC; ATTN: CREDENTIALS
Second Line	:	11505 MT BELEVEDERE BLVD
City	:	FT. DRUM
State	:	NY
Zip	:	13602-5004
Country	:	US
Telephone Number	:	315-772-4025
Fax Number	:	315-772-9498

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	06/11/2025

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