Provider Demographics
NPI:1164048302
Name:BELL-MARTIN, DENESE NATALEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DENESE
Middle Name:NATALEE
Last Name:BELL-MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5369 LEGACY TRL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-5865
Mailing Address - Country:US
Mailing Address - Phone:917-653-8281
Mailing Address - Fax:
Practice Address - Street 1:5369 LEGACY TRL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-5865
Practice Address - Country:US
Practice Address - Phone:917-653-8281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010882101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty