Provider Demographics
NPI:1972194595
Name:BELL, GRACE (LICSW)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 RHODES RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-1920
Mailing Address - Country:US
Mailing Address - Phone:360-461-5178
Mailing Address - Fax:
Practice Address - Street 1:825 E 5TH ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3818
Practice Address - Country:US
Practice Address - Phone:360-477-4790
Practice Address - Fax:360-477-4802
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC611164211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical