Provider Demographics
NPI:1225450224
Name:OLIVER, BENTLEY (LPCC)
Entity type:Individual
Prefix:
First Name:BENTLEY
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-5138
Mailing Address - Country:US
Mailing Address - Phone:505-385-5707
Mailing Address - Fax:505-898-9372
Practice Address - Street 1:5700 HARPER DR NE
Practice Address - Street 2:SUITE 300
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3573
Practice Address - Country:US
Practice Address - Phone:505-400-6609
Practice Address - Fax:505-898-9372
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0181751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional