NPIMap

Organization Active NPI

Nelson G. Bentley

  • Psychologist
  • Towson, MD
National Provider Identifier
1689853293
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
01720 Issued in MD
Legal business name
NELSON G. BENTLEY
Practice address
120 Sister Pierre Dr
Suite 107
Towson, MD 21204-7516
Phone
(410) 337-9441
Fax
(410) 339-7169
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Authorized official

Name
Nelson G Bentley, PHD
Title
Owner
Phone
(410) 337-9441

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 01720 MD Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X D0000759 MD

Addresses

Primary practice location

120 Sister Pierre Dr
Suite 107
Towson, MD 21204-7516

Mailing address

120 Sister Pierre Dr
Suite 107
Towson, MD 21204-7516
Phone (410) 337-9441

Other identifiers 1

IdentifierTypeStateIssuer
G033OtherMDBCBS

National Provider Directory

National Provider Directory

Locations

336 S Main St
Ste 1A
Bel Air, MD 21014
Phone (410) 893-0995

120 Sister Pierre Dr
Ste 107
Towson, MD 21204
Phone (410) 337-9441

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1689853293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR",
            "address_2": "SUITE 107",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047516",
            "telephone_number": "410-337-9441",
            "fax_number": "410-339-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR",
            "address_2": "SUITE 107",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047516",
            "telephone_number": "410-337-9441",
            "fax_number": "410-339-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON G. BENTLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-337-9441",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MD",
            "license": "01720",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0000759",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G033",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.