Provider Demographics
NPI:1265038061
Name:BENTLEY, WILLIAM HARRY (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HARRY
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 STONEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3919
Mailing Address - Country:US
Mailing Address - Phone:401-480-8913
Mailing Address - Fax:
Practice Address - Street 1:22 STONEY HILL RD
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3919
Practice Address - Country:US
Practice Address - Phone:401-480-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002263761041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical