Provider Demographics
NPI:1457937500
Name:BELL, REGINALD JEROME SR (MS, CSAC, ADC-SUD)
Entity type:Individual
Prefix:MR
First Name:REGINALD
Middle Name:JEROME
Last Name:BELL
Suffix:SR
Gender:M
Credentials:MS, CSAC, ADC-SUD
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
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-0971
Mailing Address - Country:US
Mailing Address - Phone:414-534-9963
Mailing Address - Fax:
Practice Address - Street 1:2323 S 109TH ST STE 120
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-1909
Practice Address - Country:US
Practice Address - Phone:414-534-9963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16681-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI823365778Medicaid