Provider Demographics
NPI:1619557543
Name:BELL, NICOLE (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33613 130TH ST
Mailing Address - Street 2:
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-4800
Mailing Address - Country:US
Mailing Address - Phone:952-457-2754
Mailing Address - Fax:
Practice Address - Street 1:1400 MADISON AVE STE 610
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5488
Practice Address - Country:US
Practice Address - Phone:507-387-3777
Practice Address - Fax:507-344-1726
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2805101YP2500X
MNCC02805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional