Provider Demographics
NPI:1255224101
Name:BENT, JOSEPHINE
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:BENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8142 HEATHERY PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-2394
Mailing Address - Country:US
Mailing Address - Phone:317-550-9854
Mailing Address - Fax:
Practice Address - Street 1:5660 CAITO DR STE 126
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-1368
Practice Address - Country:US
Practice Address - Phone:317-593-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88002786A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health