MEDICARE: MR. MAYNARD WILLIAM BELL LPC

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	14192	AZ

General Provider Information

NPI Number	:	1720399488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAYNARD WILLIAM BELL LPC

Provider Business Mailing Address
First Line	:	13460 N 94TH DR
Second Line	:	STE J-2
City	:	PEORIA
State	:	AZ
Zip	:	85381-4835
Country	:	US
Telephone Number	:	480-340-6556
Fax Number	:	623-486-8276

Provider Business Practice Location Address
First Line	:	2400 W DUNLAP AVE
Second Line	:	SUITE 300
City	:	PHOENIX
State	:	AZ
Zip	:	85021-2817
Country	:	US
Telephone Number	:	602-943-2999
Fax Number	:	602-943-4284

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	07/21/2015

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