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General NPI Number Information
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NPI Number | 1578946976
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Entity Type | Individual
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Provider Name | KYLA COLLECE BENNETT LCSW, LSCSW
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 9393 W 110TH ST STE 505
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1442
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Country | US
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Telephone | 715-220-3962
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Fax |
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Provider Business Mailing Address
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Address Line | 9924 BRIAR DR
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City | OVERLAND PARK
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State | KS
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Zip | 66207-3435
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 10630
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2019026997
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5035
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License Number State | KS
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