Provider Demographics
NPI:1457482754
Name:BELL, KANIKA (PHD)
Entity type:Individual
Prefix:DR
First Name:KANIKA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KANIKA
Other - Middle Name:
Other - Last Name:BELL-HOWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:5835 CAMPBELLTON RD SW STE 102
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8014
Mailing Address - Country:US
Mailing Address - Phone:404-941-7326
Mailing Address - Fax:
Practice Address - Street 1:5835 CAMPBELLTON RD SW STE 102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8014
Practice Address - Country:US
Practice Address - Phone:404-941-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002912103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA654914591BMedicaid
GA654914591CMedicaid