Provider Demographics
NPI:1881876308
Name:BELLA, JEANETTE LORRAINE (LMSW)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:LORRAINE
Last Name:BELLA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28502 HOOVER RD APT 3
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-5425
Mailing Address - Country:US
Mailing Address - Phone:586-596-5782
Mailing Address - Fax:586-939-1840
Practice Address - Street 1:28502 HOOVER RD APT 3
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5425
Practice Address - Country:US
Practice Address - Phone:586-596-5782
Practice Address - Fax:586-939-1840
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010869771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical