Healthcare Provider Details

I. General information

NPI: 1053239715
Provider Name (Legal Business Name): BENNETT HERBERT KERN M.S., LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 WATERFALL TRL
BELGRADE MT
59714-4294
US

IV. Provider business mailing address

2011 WATERFALL TRL
BELGRADE MT
59714-4294
US

V. Phone/Fax

Practice location:
  • Phone: 406-600-8604
  • Fax:
Mailing address:
  • Phone: 406-600-8604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberBBH-LCPC-LIC-88304
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: