Bennett, Kelly Randolph
Bennett, Kelly Randolph is an sole proprietor health care provider with primary practice located at 578 Via Arista , Santa Fe NM 87506-4507. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Bennett, Kelly Randolph can be contacted via phone (505) 577-1862.Contact Information
Primary practice address
578 Via Arista
Santa Fe NM 87506-4507
Phone: (505) 577-1862
Fax: (505) 466-9459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | LPCC 0088061 | New Mexico |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | MFC 2017 | California |
Profile Details
| NPI number | 1134302722 |
|---|---|
| LBN Legal business name | Bennett, Kelly Randolph |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2007 |
| Last updated | Apr 7th, 2008 - about 16 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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