Provider Demographics
NPI:1912276049
Name:BELL, NATHAN CHRISTOPHER (MA, LMHC)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:CHRISTOPHER
Last Name:BELL
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 S LAKELAND DR STE 3
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-4920
Mailing Address - Country:US
Mailing Address - Phone:863-644-5433
Mailing Address - Fax:863-701-7239
Practice Address - Street 1:5120 S LAKELAND DR STE 3
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4920
Practice Address - Country:US
Practice Address - Phone:863-644-5433
Practice Address - Fax:863-701-7239
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11015101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional