Provider Demographics
NPI:1336925338
Name:BENTI, BERKET G
Entity Type:Individual
Prefix:
First Name:BERKET
Middle Name:G
Last Name:BENTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 HOMEPLACE DR APT 1106
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1923
Mailing Address - Country:US
Mailing Address - Phone:571-354-1715
Mailing Address - Fax:
Practice Address - Street 1:8540 HOMEPLACE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1921
Practice Address - Country:US
Practice Address - Phone:571-354-1715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL21004005951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical