Provider Demographics
NPI:1326346321
Name:BENNETT, BARBARA S (LMFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 S MAIN ST
Mailing Address - Street 2:208
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2441
Mailing Address - Country:US
Mailing Address - Phone:860-233-4321
Mailing Address - Fax:860-233-4321
Practice Address - Street 1:45 S MAIN ST
Practice Address - Street 2:208
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2441
Practice Address - Country:US
Practice Address - Phone:860-233-4321
Practice Address - Fax:860-233-4321
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001420106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist