Provider Demographics
NPI:1134291800
Name:BELL, GWENDOLYN J (MA)
Entity Type:Individual
Prefix:MS
First Name:GWENDOLYN
Middle Name:J
Last Name:BELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S 70TH ST STE 160
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3733
Mailing Address - Country:US
Mailing Address - Phone:420-477-8278
Mailing Address - Fax:402-477-8284
Practice Address - Street 1:2900 S 70TH ST STE 160
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3733
Practice Address - Country:US
Practice Address - Phone:420-477-8278
Practice Address - Fax:402-477-8284
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1612101YM0800X
NE946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE233318OtherMIDLANDS CHOICE NEBRASKA
NE84747OtherBLUE CROSS BLUE SHIELD