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NPI Code Detail

MEDICARE: BENTLEY J ELLIOTT BCBA

MEDICARE: BENTLEY J ELLIOTT BCBA
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
1103K00000XBehavior Analyst2025052961MO

General Provider Information

NPI Number : 1689538357
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENTLEY J ELLIOTT BCBA
Provider Business Mailing Address
First Line : PO BOX 844715
Second Line :
City : KANSAS CITY
State : MO
Zip : 64184-4715
Country : US
Telephone Number : 417-761-5214
Fax Number : 417-761-5065
Provider Business Practice Location Address
First Line : 1300 E BRADFORD PKWY
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/18/2025

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Directions to “ BENTLEY J ELLIOTT BCBA” Practice Location

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