Provider Demographics
NPI:1316257074
Name:BELL, MAHOGANY MONIQUE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MAHOGANY
Middle Name:MONIQUE
Last Name:BELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:MAHOGANY
Other - Middle Name:MONIQUE
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1893 CLIFF GOOKIN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6558
Mailing Address - Country:US
Mailing Address - Phone:662-346-4584
Mailing Address - Fax:662-346-4589
Practice Address - Street 1:1893 CLIFF GOOKIN BLVD STE B
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6558
Practice Address - Country:US
Practice Address - Phone:662-346-4584
Practice Address - Fax:662-346-4589
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MSC70341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health