Provider Demographics
NPI:1851867378
Name:BENTLEY, ANDREW CHASE (MSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHASE
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 N MAY AVE STE 378
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6010
Mailing Address - Country:US
Mailing Address - Phone:405-254-6206
Mailing Address - Fax:405-497-6794
Practice Address - Street 1:5030 N MAY AVE STE 378
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6010
Practice Address - Country:US
Practice Address - Phone:405-254-6206
Practice Address - Fax:405-497-6794
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR130911041C0700X
ND62381041C0700X
OK76801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical