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General NPI Number Information
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NPI Number | 1104306950
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Entity Type | Individual
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Provider Name | LINDSAY BENNETT LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 1896 W 9525 S
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-2397
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Country | US
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Telephone | 801-842-4034
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 W BEAMON ST
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City | WEST JORDAN
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State | UT
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Zip | 84084-4800
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Country | US
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Telephone | 801-842-4034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11320560-3501
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License Number State | UT
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