Provider Demographics
NPI:1174684559
Name:BENTLEY, STEPHEN CLINTON
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:CLINTON
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 MCFARLAND BLVD N
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406
Mailing Address - Country:US
Mailing Address - Phone:205-391-9777
Mailing Address - Fax:205-391-9766
Practice Address - Street 1:1800 MCFARLAND BLVD N
Practice Address - Street 2:SUITE 230 NESMITH COUNSELING & LEARNING CENTER
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406
Practice Address - Country:US
Practice Address - Phone:205-391-9777
Practice Address - Fax:205-391-9766
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist