Provider Demographics
NPI:1285197574
Name:BELL, EUGENE EDWARD III (MFT)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:EDWARD
Last Name:BELL
Suffix:III
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25916 AVENUE 17 STE A
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-2860
Mailing Address - Country:US
Mailing Address - Phone:559-675-0105
Mailing Address - Fax:
Practice Address - Street 1:25916 AVENUE 17 STE A
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-2860
Practice Address - Country:US
Practice Address - Phone:559-615-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-1412648OtherPREVENTION INTERVENTION