Provider Demographics
NPI:1720399488
Name:BELL, MAYNARD WILLIAM (LPC)
Entity Type:Individual
Prefix:MR
First Name:MAYNARD
Middle Name:WILLIAM
Last Name:BELL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13460 N 94TH DR
Mailing Address - Street 2:STE J-2
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4835
Mailing Address - Country:US
Mailing Address - Phone:480-340-6556
Mailing Address - Fax:623-486-8276
Practice Address - Street 1:2400 W DUNLAP AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2817
Practice Address - Country:US
Practice Address - Phone:602-943-2999
Practice Address - Fax:602-943-4284
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health