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General NPI Number Information
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NPI Number | 1427526797
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Entity Type | Individual
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Provider Name | CARRISSA BENTLEY LICSW
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Gender | Female
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 3157 E 34TH AVE
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City | SPOKANE
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State | WA
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Zip | 99223-4622
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Country | US
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Telephone | 208-310-0266
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Fax |
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Provider Business Mailing Address
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Address Line | 3157 E 34TH AVE
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City | SPOKANE
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State | WA
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Zip | 99223-4622
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Country | US
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Telephone | 208-310-0266
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61234673
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License Number State | WA
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