Provider Demographics
NPI:1003674011
Name:BENDELE, ASHANTA PAIGE (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHANTA
Middle Name:PAIGE
Last Name:BENDELE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 KINGOLD BLVD
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1619
Mailing Address - Country:US
Mailing Address - Phone:252-747-2921
Mailing Address - Fax:252-221-5879
Practice Address - Street 1:1106 KINGOLD BLVD
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1619
Practice Address - Country:US
Practice Address - Phone:252-747-2921
Practice Address - Fax:252-221-5879
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0163131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical