Basic Information
Provider Information
NPI: 1437278876
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRIS-BELL
FirstName: TEWANA
MiddleName: M.
NamePrefix: MRS.
NameSuffix:  
Credential: L.M.H.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10320 PASO FINO PL SW
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871218954
CountryCode: US
TelephoneNumber: 5052611919
FaxNumber:  
Practice Location
Address1: 2403 SAN MATEO BLVD NE
Address2: SUITE S-14
City: ALBUQUERQUE
State: NM
PostalCode: 871104058
CountryCode: US
TelephoneNumber: 5058301871
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XT-0100301NMY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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