Provider Demographics
NPI:1831077098
Name:BELL, LISA LYNN (RCSWI, MSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LYNN
Last Name:BELL
Suffix:
Gender:F
Credentials:RCSWI, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-5206
Mailing Address - Country:US
Mailing Address - Phone:850-341-6710
Mailing Address - Fax:
Practice Address - Street 1:3027 LONG AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-5206
Practice Address - Country:US
Practice Address - Phone:850-341-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW211911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical