Provider Demographics
NPI:1568023414
Name:BENTLER, GRETCHEN (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:
Last Name:BENTLER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BUBBA LN
Mailing Address - Street 2:
Mailing Address - City:CLIFTON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18424-7707
Mailing Address - Country:US
Mailing Address - Phone:570-780-4327
Mailing Address - Fax:
Practice Address - Street 1:300 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1225
Practice Address - Country:US
Practice Address - Phone:570-955-5479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional