Provider Demographics
NPI:1578821120
Name:BENTLEY, BARBARA CHARLOTTE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:CHARLOTTE
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 561 PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96310-0007
Mailing Address - Country:US
Mailing Address - Phone:0804-662-1311
Mailing Address - Fax:
Practice Address - Street 1:PSC 561 BOX 1877
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96310-0019
Practice Address - Country:US
Practice Address - Phone:082-779-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD140221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical