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General NPI Number Information
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NPI Number | 1447610118
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Entity Type | Individual
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Provider Name | LAUREN MELISSA MOURIER BENTLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 440 PARK AVE STE A
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City | LEBANON
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State | TN
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Zip | 37087-3665
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Country | US
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Telephone | 423-653-1194
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Fax |
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Provider Business Mailing Address
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Address Line | 924A STROUSE AVE
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City | NASHVILLE
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State | TN
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Zip | 37206-3329
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Country | US
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Telephone | 423-653-1194
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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 | 7123
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License Number State | TN
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