Provider Demographics
NPI:1467056424
Name:BENTLEY, CONTAE IBRINIE (LSW, MED)
Entity Type:Individual
Prefix:MS
First Name:CONTAE
Middle Name:IBRINIE
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:LSW, MED
Other - Prefix:MRS
Other - First Name:CONTAE
Other - Middle Name:
Other - Last Name:BENTLEY-MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW, MED
Mailing Address - Street 1:848 E 185TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2778
Mailing Address - Country:US
Mailing Address - Phone:216-551-1496
Mailing Address - Fax:
Practice Address - Street 1:848 E 185TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-2778
Practice Address - Country:US
Practice Address - Phone:216-551-1496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0021862171M00000X, 174H00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator