Provider Demographics
NPI:1467900589
Name:BELL, SHANNA (LCMHC)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3297
Mailing Address - Country:US
Mailing Address - Phone:910-248-9234
Mailing Address - Fax:910-920-9126
Practice Address - Street 1:310 BIRCH ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3297
Practice Address - Country:US
Practice Address - Phone:910-248-9234
Practice Address - Fax:910-920-9126
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-18
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional