Provider Demographics
NPI:1699964635
Name:BELL, PAMELA JEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JEAN
Last Name:BELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4633 N WESTERN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2181
Mailing Address - Country:US
Mailing Address - Phone:312-203-3405
Mailing Address - Fax:312-203-3405
Practice Address - Street 1:4633 N WESTERN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2181
Practice Address - Country:US
Practice Address - Phone:312-203-3405
Practice Address - Fax:312-203-3405
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490097541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical