Healthcare Provider Details

I. General information

NPI: 1427073477
Provider Name (Legal Business Name): TIMOTHY FRANCIS BENNETT M.A. LPC/CAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FISHBURN RD
HERSHEY PA
17033-2015
US

IV. Provider business mailing address

825 FISHBURN RD
HERSHEY PA
17033-2015
US

V. Phone/Fax

Practice location:
  • Phone: 717-533-7404
  • Fax: 717-520-1295
Mailing address:
  • Phone: 717-533-7404
  • Fax: 717-520-1295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number227064
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC001611
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierA257595
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerVALUE OPTIONS
# 2
Identifier50000176
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAPITAL BLUE CROSS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: