Provider Demographics
NPI:1285788331
Name:BELL, TIWANA RENEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TIWANA
Middle Name:RENEE
Last Name:BELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 ALHAMBRA DR
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:TX
Mailing Address - Zip Code:76119-7305
Mailing Address - Country:US
Mailing Address - Phone:817-709-3178
Mailing Address - Fax:
Practice Address - Street 1:2601 AIRPORT FWY
Practice Address - Street 2:STE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-2379
Practice Address - Country:US
Practice Address - Phone:817-899-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX298681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166451801Medicaid