Provider Demographics
NPI:1578681953
Name:BELL, ANITA G (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:G
Last Name:BELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 E SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1329
Mailing Address - Country:US
Mailing Address - Phone:215-753-1330
Mailing Address - Fax:215-753-1333
Practice Address - Street 1:609 E SEDGWICK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1329
Practice Address - Country:US
Practice Address - Phone:215-753-1330
Practice Address - Fax:215-753-1333
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002640-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE161407OtherBLUE SHIELD
PA119525OtherMANAGED HEALTH NETWORK
PA4288486OtherAETNA
PA0063020000OtherPERSONAL CHOICE
PAQ64273OtherAMERIHEALTH