Healthcare Provider Details

I. General information

NPI: 1770131468
Provider Name (Legal Business Name): TESS BENNETT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 HALL ST # 5
HAYS KS
67601-1964
US

IV. Provider business mailing address

2703 HALL ST # 5
HAYS KS
67601-1964
US

V. Phone/Fax

Practice location:
  • Phone: 785-261-0694
  • Fax: 785-261-0697
Mailing address:
  • Phone: 785-261-0694
  • Fax: 785-261-0697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. TERESEA L BENNETT
Title or Position: OWNER
Credential: LSCSW
Phone: 785-623-3482