Provider Demographics
NPI:1568184679
Name:BELL, LAKESHIA LATICE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:LAKESHIA
Middle Name:LATICE
Last Name:BELL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12014 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-6338
Mailing Address - Country:US
Mailing Address - Phone:312-613-3327
Mailing Address - Fax:
Practice Address - Street 1:12014 S UNION AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-6338
Practice Address - Country:US
Practice Address - Phone:312-613-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150105703104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker