Healthcare Provider Details

I. General information

NPI: 1386578326
Provider Name (Legal Business Name): MRS. ERIN MULLANEY BENNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BLACKBURN CTR
GLOUCESTER MA
01930-2268
US

IV. Provider business mailing address

33 CRESCENT AVE
BEVERLY MA
01915-4143
US

V. Phone/Fax

Practice location:
  • Phone: 978-283-7198
  • Fax:
Mailing address:
  • Phone: 978-886-1196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: