Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1477074326 Deactivated / Inactive NPI Male Practitioner

Jack E Bentham

Psychologist - Counseling • Granbury, TX

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jack Bentham has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 30, 2017
NPI Deactivation Date May 29, 2025
Total Practice Duration ~8 Years of Practice (2017 – 2025)

Professional Overview & Biography Verified Profile Summary

Jack Bentham was a registered Psychologist - Counseling practicing in Granbury, TX. Throughout an active medical career spanning 8 years, Jack Bentham provided care at the practice location at 4710 ESPLANADE CT until profile deactivation on 2025-05-29.

Historical Medicare Part B clinical services included psychotherapy. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4710 Esplanade Ct

Granbury, TX 760494010

Telephone 8172194599
Fax 8172194599
Associated Practice Facility / Clinic
🏢 Benthambenterprises, Ltd Facility NPI 1043730385

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Counseling in Granbury, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Granbury, TX (538 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
39.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90834 Psychotherapy, 45 minutes
29 12 $150.00 $91.15

Medical Specialties & State Licenses

Psychologist - Counseling Primary Specialty

NUCC Taxonomy Code: 103TC1900X

State License TX 36233

A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated May 29, 2025

Record deactivated on May 29, 2025

NPI Profile Active June 30, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 30, 2017

Registered at 4710 ESPLANADE CT, GRANBURY, TX 760494010 (Tel: 8172194599)

📍
Updated Business Mailing Address June 30, 2017

Registered at 4710 ESPLANADE CT, GRANBURY, TX 760494010 (Tel: 8172194599)

👤
Provider Name / Credentials Updated June 30, 2017

Recorded as JACK BENTHAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 30, 2017

Psychologist (License #36233 in TX)

🟢
Initial NPI Registration & Enumeration June 30, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jack Bentham. Be the first to share your experience!

Sign in to leave a review for Jack Bentham

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1477074326
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2017
Last Update: June 30, 2017
Deactivation Date: May 29, 2025

Mailing Address

4710 Esplanade Ct

Granbury, TX 760494010

Phone: 8172194599

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.