Provider Demographics
NPI:1962036699
Name:REESCANO, BENNETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:BENNETTE
Middle Name:
Last Name:REESCANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1767
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-1767
Mailing Address - Country:US
Mailing Address - Phone:713-540-9381
Mailing Address - Fax:
Practice Address - Street 1:2549 ROY RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8604
Practice Address - Country:US
Practice Address - Phone:281-485-9280
Practice Address - Fax:281-485-9070
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical