Basic Information
| Provider Information | |||||||||
| NPI: | 1255575452 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | CEDRIC | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.H.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1822 SPRING GARDEN ST | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191304122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155640680 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1822 SPRING GARDEN ST | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191304122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155640680 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2009 | ||||||||
| LastUpdateDate: | 03/13/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 101YAO400X | PA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.