Provider Demographics
NPI:1073971040
Name:BENTLEY, ROBYN (LPC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:PALMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12316 E BROCK PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-1903
Mailing Address - Country:US
Mailing Address - Phone:225-315-3568
Mailing Address - Fax:
Practice Address - Street 1:12316 E BROCK PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-1903
Practice Address - Country:US
Practice Address - Phone:225-315-3568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional