Provider Demographics
NPI:1710763198
Name:BELL, SHAYNA
Entity Type:Individual
Prefix:MRS
First Name:SHAYNA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 99TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-5525
Mailing Address - Country:US
Mailing Address - Phone:515-635-3300
Mailing Address - Fax:515-635-3344
Practice Address - Street 1:2980 99TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-5525
Practice Address - Country:US
Practice Address - Phone:515-635-3300
Practice Address - Fax:515-635-3344
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health