Provider Demographics
NPI:1922497833
Name:JENNINGS, BENJAMIN F (LCPC, LMFT, LAC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:F
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:LCPC, LMFT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-4404
Mailing Address - Country:US
Mailing Address - Phone:406-301-8011
Mailing Address - Fax:
Practice Address - Street 1:220 3RD AVE STE 407B
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3554
Practice Address - Country:US
Practice Address - Phone:406-301-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-28156101YA0400X
MTBBH-LMFT-LIC-39452106H00000X
MTBBH-LCPC-LIC-23765101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist