Bennett, Durie T

Bennett, Durie T is an individual health care provider with primary practice located at 4501 Rt 176 , Crystal Lake IL 60014. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Bennett, Durie T can be contacted via phone (815) 477-4003.

Contact Information

Primary practice address
4501 Rt 176 Crystal Lake IL 60014
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X Illinois

Profile Details

NPI number 1255493912
LBN Legal business name Bennett, Durie T
Credentials MA LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255493912 NPPES
Other 5615166 BLUE CROSS

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