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NPI Code Detail

MEDICARE: DEANNA BEATRICE BENNETT LPC-IT

MEDICARE: DEANNA BEATRICE BENNETT LPC-IT
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
1101YM0800XMental Health Counselor7999-226WI

General Provider Information

NPI Number : 1891531588
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA BEATRICE BENNETT LPC-IT
Provider Business Mailing Address
First Line : 251 PROGRESS WAY STE 102
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-2520
Country : US
Telephone Number : 608-849-5430
Fax Number :
Provider Business Practice Location Address
First Line : 251 PROGRESS WAY STE 102
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-2520
Country : US
Telephone Number : 608-849-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2024
Last Update Date : 07/02/2024

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Directions to “ DEANNA BEATRICE BENNETT LPC-IT” Practice Location

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