MEDICARE: MRS. DIANE BELL

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
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1619966843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANE BELL

Provider Business Mailing Address
First Line	:	2319 SAINT MATTHEWS RD
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-2042
Country	:	US
Telephone Number	:	803-536-1571
Fax Number	:	803-534-3860

Provider Business Practice Location Address
First Line	:	2319 SAINT MATTHEWS RD
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-2042
Country	:	US
Telephone Number	:	803-536-1571
Fax Number	:	803-534-3860

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	03/13/2019

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