Active NPI
Lisa Renaye Bentley, LPC
- Mental Health Counselor
- Statesville, NC
National Provider Identifier
1629314216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4233
- Practice address
- 209 Barium Springs Drive
Statesville, NC 28677-6238 - Phone
- (707) 873-1011
- Fax
- (704) 832-2253
- NPI assigned
- Dec 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4233 | NC | Primary |
Addresses
Primary practice location
209 Barium Springs Drive
Statesville, NC 28677-6238
Mailing address
PO Box 1
Barium Springs, NC 28010-0001
Phone (707) 873-1011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4233 | Other | NC | LPC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4233 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357084800000",
"number": "1629314216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1",
"city": "BARIUM SPRINGS",
"state": "NC",
"postal_code": "280100001",
"telephone_number": "707-873-1011",
"fax_number": "704-832-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 BARIUM SPRINGS DRIVE",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286776238",
"telephone_number": "707-873-1011",
"fax_number": "704-832-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "LISA",
"middle_name": "RENAYE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2013-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "4233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "4233",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.