Provider Demographics
NPI:1346693280
Name:BENNETT, KATE CORINNE (MSW, CAPSW)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:CORINNE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MSW, CAPSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:CORINNE
Other - Last Name:GOEDTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, CAPSW
Mailing Address - Street 1:3195 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2189
Mailing Address - Country:US
Mailing Address - Phone:262-646-9960
Mailing Address - Fax:262-646-9961
Practice Address - Street 1:3195 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2189
Practice Address - Country:US
Practice Address - Phone:262-646-9960
Practice Address - Fax:262-646-9961
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1346693280Medicaid