Bennett, Phillip Whayne
Bennett, Phillip Whayne is an individual health care provider with primary practice located at 146 Pike Street , Port Jervis NY 12771. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bennett, Phillip Whayne can be contacted via phone (845) 858-1456.Contact Information
Primary practice address
146 Pike Street
Port Jervis NY 12771
Phone: (845) 858-1456
Fax: (845) 858-1459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 075663-1 | New York |
Profile Details
| NPI number | 1629223730 |
|---|---|
| LBN Legal business name | Bennett, Phillip Whayne |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 18th, 2008 |
| Last updated | Sep 22nd, 2009 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629223730 | NPPES |
| New York | MEDICAID | 03004253 |
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