Provider Demographics
NPI:1104248384
Name:BELL, PETER (LCSW)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:BELL
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:POLLY
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2724 CADY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97530-9431
Mailing Address - Country:US
Mailing Address - Phone:404-680-6662
Mailing Address - Fax:706-250-9945
Practice Address - Street 1:2282 EASTWAY RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5508
Practice Address - Country:US
Practice Address - Phone:404-680-6662
Practice Address - Fax:706-250-9945
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0050701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical