Individual provider Active NPI

Jarris Dejuan Bell, BSW, MSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1093148553
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009752 Issued in NC
Practice address
2225 Freedom Dr Ste 2
Charlotte, NC 28208-4035
Phone
(704) 537-7775
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C009752 NC Primary

Addresses

Primary practice location

2225 Freedom Dr Ste 2
Charlotte, NC 28208-4035

Mailing address

2225 Freedom Dr Ste 2
Charlotte, NC 28208-4035
Phone (704) 537-7775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190319000107 NC Practitioner - Clinical Social Worker 3678813276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1093148553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 FREEDOM DR STE 2",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084035",
            "telephone_number": "704-537-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 FREEDOM DR STE 2",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282084035",
            "telephone_number": "704-537-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "JARRIS",
        "middle_name": "DEJUAN",
        "credential": "BSW, MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.