MEDICARE: SUMMER DANIELLE 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	3106	KY

General Provider Information

NPI Number	:	1811140916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMMER DANIELLE BELL LCSW

Provider Business Mailing Address
First Line	:	2816 VEACH RD STE 208
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-6299
Country	:	US
Telephone Number	:	270-315-1228
Fax Number	:	270-228-0341

Provider Business Practice Location Address
First Line	:	2816 VEACH RD STE 208
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-6299
Country	:	US
Telephone Number	:	270-315-1228
Fax Number	:	270-228-0341

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	03/14/2019

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