MEDICARE: JEAN BELL WILLIAMS

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	101YM0800X	Mental Health Counselor	10828	TX

General Provider Information

NPI Number	:	1508404195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN BELL WILLIAMS

Provider Business Mailing Address
First Line	:	PO BOX 1715
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-0010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 S WESTMORELAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-2998
Country	:	US
Telephone Number	:	214-632-1575
Fax Number	:

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

Provider Enumeration Date	:	12/15/2019
Last Update Date	:	12/15/2019

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Directions to “ JEAN BELL WILLIAMS ” Practice Location

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