Provider Demographics
NPI:1811644503
Name:BELL, JENNY LEE (LICSW)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:LEE
Last Name:BELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:LEE
Other - Last Name:FRAZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:ASHFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36312-3439
Mailing Address - Country:US
Mailing Address - Phone:334-791-2923
Mailing Address - Fax:
Practice Address - Street 1:104 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:ASHFORD
Practice Address - State:AL
Practice Address - Zip Code:36312-3439
Practice Address - Country:US
Practice Address - Phone:334-791-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4695C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical