Provider Demographics
NPI:1447672662
Name:BENTLEY, OLIVIA (LPCC)
Entity type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:
Last Name:BENTLEY
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 1:1589 HILL RISE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2588
Mailing Address - Country:US
Mailing Address - Phone:859-255-0890
Mailing Address - Fax:
Practice Address - Street 1:1589 HILL RISE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2588
Practice Address - Country:US
Practice Address - Phone:859-255-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCPCC00214790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional