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General NPI Number Information
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NPI Number | 1114794088
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Entity Type | Individual
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Provider Name | LAWRENCE CARL BENTLEY LCADC
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Gender | Male
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 1655 KY-3094
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City | EAST BERNSTADT
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State | KY
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Zip | 40729
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Country | US
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Telephone | 606-729-5372
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Fax |
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Provider Business Mailing Address
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Address Line | 637D ANDERS RD
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City | LONDON
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State | KY
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Zip | 40744-7828
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Country | US
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Telephone | 606-312-3496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 281821
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 290104
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License Number State | KY
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