Provider Demographics
NPI:1457635989
Name:BELL, SHAWNA KATHLEEN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:KATHLEEN
Last Name:BELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 LARRY ST
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-5438
Mailing Address - Country:US
Mailing Address - Phone:707-496-2856
Mailing Address - Fax:
Practice Address - Street 1:381 BAYSIDE RD
Practice Address - Street 2:SUITE C
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6497
Practice Address - Country:US
Practice Address - Phone:707-496-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 47122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist