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General NPI Number Information
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NPI Number | 1396801700
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Entity Type | Individual
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Provider Name | NANCY S. BENNETT LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3211 LIBERTY ST SUITE LL2
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City | ERIE
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State | PA
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Zip | 16508-2575
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Country | US
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Telephone | 814-868-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 4107 MCKEE RD
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City | ERIE
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State | PA
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Zip | 16506-3701
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Country | US
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Telephone | 814-833-1411
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Fax | 814-835-1771
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CW013071
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License Number State | PA
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