Provider Demographics
NPI:1720852049
Name:BENDELE FAMILY THERAPY, INC
Entity Type:Organization
Organization Name:BENDELE FAMILY THERAPY, INC
Other - Org Name:BENDELE BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDELE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, BCBA-D
Authorized Official - Phone:805-878-6531
Mailing Address - Street 1:1263 GRAND MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:ORCUTT
Mailing Address - State:CA
Mailing Address - Zip Code:93455-2879
Mailing Address - Country:US
Mailing Address - Phone:805-878-6531
Mailing Address - Fax:
Practice Address - Street 1:195 S BROADWAY ST STE 205
Practice Address - Street 2:
Practice Address - City:ORCUTT
Practice Address - State:CA
Practice Address - Zip Code:93455-4656
Practice Address - Country:US
Practice Address - Phone:602-400-9516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty