Provider Demographics
NPI:1235280322
Name:BENNETT, HOLLY H (LCSW)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:H
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 LIGURIAN RD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-818-3246
Mailing Address - Fax:
Practice Address - Street 1:900 S. U.S. HIGHWAY ONE, STE 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477
Practice Address - Country:US
Practice Address - Phone:561-818-3246
Practice Address - Fax:561-743-3329
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 52911041C0700X
FLSW52911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical