Provider Demographics
NPI:1225423643
Name:BENNATI, ADAM CHRISTOPHER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:BENNATI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W LINCOLN HWY
Mailing Address - Street 2:SUITE 50 WEST
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2521
Mailing Address - Country:US
Mailing Address - Phone:610-594-2141
Mailing Address - Fax:610-594-3687
Practice Address - Street 1:407 W LINCOLN HWY
Practice Address - Street 2:SUITE 50 WEST
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2521
Practice Address - Country:US
Practice Address - Phone:610-594-2141
Practice Address - Fax:610-594-3687
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007812101YP2500X
PAMF000798106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional