Provider Demographics
NPI:1922188077
Name:BELL, ELIZABETH CONWAY II
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CONWAY
Last Name:BELL
Suffix:II
Gender:F
Credentials:
Other - Prefix:PROF
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:CONWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:557 PELICAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9249
Mailing Address - Country:US
Mailing Address - Phone:985-845-0531
Mailing Address - Fax:
Practice Address - Street 1:200 S TYLER ST
Practice Address - Street 2:SUITE 202-B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3036
Practice Address - Country:US
Practice Address - Phone:985-867-1434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health