Provider Demographics
NPI:1194014787
Name:WHITE BELL, CAROLYN W (LPC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:W
Last Name:WHITE BELL
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 1:15012 SWAN LAKE PL
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-8295
Mailing Address - Country:US
Mailing Address - Phone:228-234-5779
Mailing Address - Fax:228-206-1615
Practice Address - Street 1:15012 SWAN LAKE PL
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-8295
Practice Address - Country:US
Practice Address - Phone:228-234-5779
Practice Address - Fax:228-206-1615
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0946101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional