Provider Demographics
NPI:1619186988
Name:BELL, TRACY (MA LPC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 WEATHERSBY ST
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-3317
Mailing Address - Country:US
Mailing Address - Phone:409-386-2905
Mailing Address - Fax:
Practice Address - Street 1:531 WEATHERSBY ST
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-3317
Practice Address - Country:US
Practice Address - Phone:409-386-2905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19274101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional