National Provider Identifier

Shannon Bentley, CLC

Shannon Bentley, CLC is listed in the NPPES registry with a primary specialty of Lactation Consultant (Non-RN) in Ithaca, NY and a listed phone number of (888) 991-6772.

NPI 1497636823Ithaca, NYLactation Consultant (Non-RN)

Profile Overview

NPI
1497636823
Provider Type
Individual
Primary Specialty
Lactation Consultant (Non-RN)
Enumeration Date
September 11, 2025
Last Updated
September 11, 2025

Practice Location

  • 314 E State St
  • Ithaca, NY 14850-4318

Phone: (888) 991-6772

Mailing Address

  • 1233 S Gilbert RD Apt 6308
  • Gilbert, AZ 85296-4902

Specialties

  • Lactation Consultant (Non-RN) (174N00000X)
Full Record
NPI
1497636823
Entity Type
Individual
Last Name
Bentley
First Name
Shannon
Credential
CLC
Mailing Street Address
1233 S Gilbert RD Apt 6308
Mailing City
Gilbert
Mailing State
AZ
Mailing ZIP Code
85296-4902
Mailing Country
US
Practice Street Address
314 E State St
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-4318
Practice Country
US
Practice Phone
(888) 991-6772
Enumeration Date
September 11, 2025
Last Updated
September 11, 2025
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193200000X Multi-Specialty Group
Certification Date
September 11, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Lactation Consultant (Non-RN) (174N00000X)