Provider Demographics
NPI:1003387267
Name:BELL, HEATHER (LCPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 W 16TH ST APT 102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2863
Mailing Address - Country:US
Mailing Address - Phone:248-767-9401
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 424
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3844
Practice Address - Country:US
Practice Address - Phone:312-841-8660
Practice Address - Fax:312-841-8660
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180012721OtherLCPC