Provider Demographics
NPI:1710462916
Name:BENNETT'S COUNSELING SERVICES
Entity Type:Organization
Organization Name:BENNETT'S COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE LICENSED COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:MCMEANS
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER OF SCIENCE IN
Authorized Official - Phone:334-382-5736
Mailing Address - Street 1:1478 OLD CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-6159
Mailing Address - Country:US
Mailing Address - Phone:334-382-5736
Mailing Address - Fax:334-382-0330
Practice Address - Street 1:1478 OLD CENTRAL RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-6159
Practice Address - Country:US
Practice Address - Phone:334-382-5736
Practice Address - Fax:334-382-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty