Provider Demographics
NPI:1366164832
Name:BELL-TOLLIVER, LAVERNE (PHD, LCSW, RPT-S)
Entity type:Individual
Prefix:DR
First Name:LAVERNE
Middle Name:
Last Name:BELL-TOLLIVER
Suffix:
Gender:F
Credentials:PHD, LCSW, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 45342
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72214
Mailing Address - Country:US
Mailing Address - Phone:870-816-5169
Mailing Address - Fax:501-374-1458
Practice Address - Street 1:425 W. BROADWAY, SUITE J
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114
Practice Address - Country:US
Practice Address - Phone:501-374-5408
Practice Address - Fax:501-374-1458
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1926C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical