Provider Demographics
NPI:1275717399
Name:BENNETT, JUDY SANDRA (LPC)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:SANDRA
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JUDY
Other - Middle Name:SANDRA
Other - Last Name:SULAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC LMFT
Mailing Address - Street 1:215 CHEYENNE COURT
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-277-6502
Mailing Address - Fax:
Practice Address - Street 1:215 CHEYENNE COURT
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-277-6502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3168101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor