Healthcare Provider Details

I. General information

NPI: 1568523785
Provider Name (Legal Business Name): KARYN D BENTLEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARYN PERRY

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12016 ORCHARD VIEW DR STE 103
SAINT LOUIS MO
63146-5225
US

IV. Provider business mailing address

12016 ORCHARD VIEW DR
SAINT LOUIS MO
63146-5225
US

V. Phone/Fax

Practice location:
  • Phone: 913-284-6739
  • Fax:
Mailing address:
  • Phone: 816-612-9092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2002030472
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: