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NPI Code Detail

MEDICARE: GINA L BENTZ PSYD

MEDICARE:   GINA L BENTZ  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20042412AIN

General Provider Information

NPI Number : 1275601791
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA L BENTZ PSYD
Provider Business Mailing Address
First Line : 720 N MARR RD
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-6660
Country : US
Telephone Number : 812-314-3400
Fax Number : 812-378-8367
Provider Business Practice Location Address
First Line : 1260 E BUCKEYE ST
Second Line :
City : NORTH VERNON
State : IN
Zip : 47265-8343
Country : US
Telephone Number : 812-346-4468
Fax Number : 812-378-8367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 05/18/2026

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Directions to “ GINA L BENTZ PSYD” Practice Location

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