Provider Demographics
NPI:1356130546
Name:BELL, AUDREY JEANINE (MSW, LSW)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:JEANINE
Last Name:BELL
Suffix:
Gender:
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:OH
Mailing Address - Zip Code:44050-0161
Mailing Address - Country:US
Mailing Address - Phone:216-438-0857
Mailing Address - Fax:
Practice Address - Street 1:4578 SANTINA WAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-4400
Practice Address - Country:US
Practice Address - Phone:440-529-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.23091731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical