Provider Demographics
NPI:1679817399
Name:BELL, LATONYA RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:LATONYA
Middle Name:RENEE
Last Name:BELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 LINDBERGH DR NE
Mailing Address - Street 2:APT 7204
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3637
Mailing Address - Country:US
Mailing Address - Phone:678-237-3980
Mailing Address - Fax:
Practice Address - Street 1:3006 CLAIRMONT RD NE
Practice Address - Street 2:115
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-1602
Practice Address - Country:US
Practice Address - Phone:678-302-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional