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NPI Code Detail

MEDICARE: JOFFREE LYNETTE BENNETT

MEDICARE: JOFFREE LYNETTE BENNETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker12983-CNV

General Provider Information

NPI Number : 1467744003
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOFFREE LYNETTE BENNETT
Provider Business Mailing Address
First Line : 201 S GIBSON RD APT 3214
Second Line :
City : HENDERSON
State : NV
Zip : 89012-2665
Country : US
Telephone Number : 702-272-7712
Fax Number : 702-438-4673
Provider Business Practice Location Address
First Line : 201 S GIBSON RD APT 3214
Second Line :
City : HENDERSON
State : NV
Zip : 89012-2665
Country : US
Telephone Number : 702-272-7712
Fax Number : 702-438-4673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2011
Last Update Date : 02/18/2026

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Directions to “ JOFFREE LYNETTE BENNETT ” Practice Location

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