Provider Demographics
NPI:1992285837
Name:BELL, JERMINI
Entity type:Individual
Prefix:MS
First Name:JERMINI
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6685 SULLIVAN ROAD STE. B
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739
Mailing Address - Country:US
Mailing Address - Phone:225-261-7143
Mailing Address - Fax:877-894-8616
Practice Address - Street 1:6685 SULLIVAN ROAD SUITE B
Practice Address - Street 2:
Practice Address - City:GREENWELL SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70739-3112
Practice Address - Country:US
Practice Address - Phone:225-261-7143
Practice Address - Fax:225-250-1026
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health