Provider Demographics
NPI:1073839676
Name:BELL, SAMANTHA ANNE (MED LPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANNE
Last Name:BELL
Suffix:
Gender:F
Credentials:MED LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 NW 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-7202
Mailing Address - Country:US
Mailing Address - Phone:405-842-7284
Mailing Address - Fax:405-418-0324
Practice Address - Street 1:1017 NW 6TH STREET
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-7202
Practice Address - Country:US
Practice Address - Phone:405-842-7284
Practice Address - Fax:405-418-0324
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional