Jordan Nicole Bentley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2021008924 Issued in MO

Practice address

2807 Amberwood CT
Columbia, MO 65203-4734

Phone

(217) 415-3406

NPI assigned

Apr 13, 2021

Last updated

Apr 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1548840507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 AMBERWOOD CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034734",
            "telephone_number": "217-415-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 AMBERWOOD CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034734",
            "telephone_number": "217-415-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2021008924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karmen Bennett, ME.D.
• Kimberly Bennett, RN
• Kelsey M Benskin, MSW, LCSW
• Jacob William Benson, MD
• Amy J Bentinganan, MS,OTR/L
• Mary Beth Benton, MD
• Joela R Berardelli, MSW, LMSW
• Deborah Eva Berardi, MSW, LCSW
• Darrah Berck, M.D.
• Madeleine Berg

• Clinical Social Worker in Columbia, MO
• Providers in Columbia, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.