Individual
NANCY BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
265 E CHUBBUCK ROAD, CHUBBUCK, ID 83202-5055
(208) 237-1711
(208) 237-9806
Mailing address
265 E CHUBBUCK ROAD, CHUBBUCK, ID 83202-5055
(208) 237-1711
(208) 237-9806
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC 4707
ID
101YP2500X
Professional Counselor
LCPC- 4707
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807197600
—
ID
Enumeration date
04/11/2007
Last updated
02/16/2023
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