Provider Demographics
NPI:1972979763
Name:BELL, CHARLENE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:NY
Mailing Address - Zip Code:14838-9704
Mailing Address - Country:US
Mailing Address - Phone:650-815-1484
Mailing Address - Fax:
Practice Address - Street 1:127 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:NY
Practice Address - Zip Code:14838-9704
Practice Address - Country:US
Practice Address - Phone:650-815-1484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-15
Last Update Date:2025-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP03083103TC0700X
NY027193103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical