Provider Demographics
NPI:1891823423
Name:BENNETT, MONA E (PHD, HSP)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:E
Last Name:BENNETT
Suffix:
Gender:F
Credentials:PHD, HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7252
Mailing Address - Country:US
Mailing Address - Phone:615-771-1100
Mailing Address - Fax:615-771-1109
Practice Address - Street 1:354 COOL SPRINGS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-7252
Practice Address - Country:US
Practice Address - Phone:615-771-1100
Practice Address - Fax:615-771-1109
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2593103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
4202888OtherBCBS
TN723455000OtherMAGELLAN
4202888OtherBCBS