MEDICARE: DR. LISA MARIE BELL PH.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	022126	NY
2	103TC0700X	Clinical Psychologist	6301008842	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022126	OTHER	NY	PSYCHOLOGY LICENSE NY
2	383619278	OTHER	MI	FEDERAL TAX ID
3	6301009942	OTHER	MI	PSYCHOLOGY LICENCE #
4	680C347210	OTHER	MI	BC/BS

General Provider Information

NPI Number	:	1821017948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA MARIE BELL PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 344
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48805-0344
Country	:	US
Telephone Number	:	517-203-5056
Fax Number	:	517-203-5057

Provider Business Practice Location Address
First Line	:	4261 ANGELA WAY
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-9654
Country	:	US
Telephone Number	:	517-381-1062
Fax Number	:	517-203-5057

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	05/22/2026

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