Provider Demographics
NPI:1992343396
Name:MURDOCK-BELL, TESSA NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:NICOLE
Last Name:MURDOCK-BELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:NICOLE
Other - Last Name:MURDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:459 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-7244
Mailing Address - Country:US
Mailing Address - Phone:208-906-3816
Mailing Address - Fax:208-315-6171
Practice Address - Street 1:459 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-7244
Practice Address - Country:US
Practice Address - Phone:208-906-3816
Practice Address - Fax:208-315-6171
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-391701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical