Provider Demographics
NPI:1437744208
Name:BENNION, SCOTT (MDIV, WHC, BCPC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:BENNION
Suffix:
Gender:M
Credentials:MDIV, WHC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4084
Mailing Address - Country:US
Mailing Address - Phone:480-525-7284
Mailing Address - Fax:
Practice Address - Street 1:7901 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4084
Practice Address - Country:US
Practice Address - Phone:480-525-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral