Provider Demographics
NPI:1720295389
Name:BELL, EARL J (LCSW)
Entity type:Individual
Prefix:MR
First Name:EARL
Middle Name:J
Last Name:BELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 GOLDSMITH LN
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1038
Mailing Address - Country:US
Mailing Address - Phone:502-713-2555
Mailing Address - Fax:
Practice Address - Street 1:2210 GOLDSMITH LN
Practice Address - Street 2:SUITE 109
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1038
Practice Address - Country:US
Practice Address - Phone:502-713-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY30091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical