Provider Demographics
NPI:1548694664
Name:BELL, JENNIE MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:MARIE
Last Name:BELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2485 COMO AVE STE 550
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-1469
Mailing Address - Country:US
Mailing Address - Phone:651-969-2263
Mailing Address - Fax:651-969-2360
Practice Address - Street 1:211 HOLMES ST W STE 302
Practice Address - Street 2:
Practice Address - City:DETROIT LAKES
Practice Address - State:MN
Practice Address - Zip Code:56501-9905
Practice Address - Country:US
Practice Address - Phone:888-818-2618
Practice Address - Fax:320-316-2088
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN293861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical