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General NPI Number Information
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NPI Number | 1609657196
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Entity Type | Organization
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Legal Business Name | CASEY BENNETT COUNSELING, LLC
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 406 NEEPIER RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-4030
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Country | US
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Telephone | 301-615-2301
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | BROOKLANDVILLE
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State | MD
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Zip | 21022-0548
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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 | OWNER/COUNSELOR
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Name | CASEY BENNETT
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Credential | LCPC
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Telephone | 301-615-2301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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