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NPI Code Detail

MEDICARE: MR. ADRIAN VANTRICE BENNETT LPC

MEDICARE: MR. ADRIAN VANTRICE BENNETT LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3954TN

General Provider Information

NPI Number : 1013170075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADRIAN VANTRICE BENNETT LPC
Provider Business Mailing Address
First Line : 2021 21ST AVE
Second Line : SUITE C400
City : NASHVILLE
State : TN
Zip : 37212-4350
Country : US
Telephone Number : 615-748-0625
Fax Number : 615-369-3059
Provider Business Practice Location Address
First Line : 2021 21ST AVE
Second Line : SUITE C400
City : NASHVILLE
State : TN
Zip : 37212-4350
Country : US
Telephone Number : 615-748-0625
Fax Number : 615-369-3059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2008
Last Update Date : 08/20/2021

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