Provider Demographics
NPI:1588002760
Name:BELL, DIANA M (LCSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:M
Last Name:BELL
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988 S SUB STATION RD
Mailing Address - Street 2:P.O. BOX 1022
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-9430
Mailing Address - Country:US
Mailing Address - Phone:208-631-2659
Mailing Address - Fax:
Practice Address - Street 1:2719 S KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5623
Practice Address - Country:US
Practice Address - Phone:208-459-6557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-282771041C0700X
IDLMFT-3010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist