Provider Demographics
NPI:1649771551
Name:BELL, LOGAN (MS)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 IMMOKALEE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-4807
Mailing Address - Country:US
Mailing Address - Phone:239-351-1475
Mailing Address - Fax:
Practice Address - Street 1:1185 IMMOKALEE RD STE 220
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-4807
Practice Address - Country:US
Practice Address - Phone:239-351-1475
Practice Address - Fax:239-351-1540
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16708101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health