Provider Demographics
NPI:1891137907
Name:BENTLEY, EUGENE JR (LPC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:BENTLEY
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12316 E BROCK PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-1903
Mailing Address - Country:US
Mailing Address - Phone:225-572-1944
Mailing Address - Fax:
Practice Address - Street 1:301 N. MAIN STREET SUITE 2200
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70825-3779
Practice Address - Country:US
Practice Address - Phone:225-572-1944
Practice Address - Fax:225-572-1944
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health