Provider Demographics
NPI:1538280151
Name:BELL, JOHN KONRAD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KONRAD
Last Name:BELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 NEW LAGRANGE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4871
Mailing Address - Country:US
Mailing Address - Phone:502-423-0212
Mailing Address - Fax:502-426-0336
Practice Address - Street 1:7410 NEW LAGRANGE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4871
Practice Address - Country:US
Practice Address - Phone:502-423-0212
Practice Address - Fax:502-426-0336
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0006101YA0400X
KY11661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical