Provider Demographics
NPI:1336830264
Name:BELL, CHARLISE DALENA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CHARLISE
Middle Name:DALENA
Last Name:BELL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S HULL ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1127
Mailing Address - Country:US
Mailing Address - Phone:610-781-4787
Mailing Address - Fax:
Practice Address - Street 1:619 CHURCH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-2215
Practice Address - Country:US
Practice Address - Phone:610-781-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015590101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional