Provider Demographics
NPI:1790417038
Name:BELL, TREVOR RYAN (LCSW)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:RYAN
Last Name:BELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:TREVOR
Other - Middle Name:RYAN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:319 WILDER ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-1731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:319 WILDER ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1731
Practice Address - Country:US
Practice Address - Phone:508-825-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2273281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical