Provider Demographics
NPI:1982368460
Name:BENNETT, VENETIA L (PHD, LMFT, MEDFT)
Entity Type:Individual
Prefix:
First Name:VENETIA
Middle Name:L
Last Name:BENNETT
Suffix:
Gender:F
Credentials:PHD, LMFT, MEDFT
Other - Prefix:
Other - First Name:VENETIA
Other - Middle Name:L
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13380 SW 6TH PL
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3180
Mailing Address - Country:US
Mailing Address - Phone:954-263-6535
Mailing Address - Fax:
Practice Address - Street 1:3521 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33312-1048
Practice Address - Country:US
Practice Address - Phone:954-587-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2757101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health