Provider Demographics
NPI:1811005119
Name:BELL, LINDA J (MSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:BELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:PESAVENTO BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10201 W LINCOLN AVE
Mailing Address - Street 2:308
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2136
Mailing Address - Country:US
Mailing Address - Phone:414-329-7000
Mailing Address - Fax:414-329-7010
Practice Address - Street 1:10201 W LINCOLN AVE
Practice Address - Street 2:308
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2136
Practice Address - Country:US
Practice Address - Phone:414-329-7000
Practice Address - Fax:414-329-7010
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI188123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39241400Medicaid
WI000784158Medicare ID - Type Unspecified