Johnson, Benton Kurt
Johnson, Benton Kurt is an individual health care provider with primary practice located at 2424 40Th Ave Apt 6 , Moline IL 61265-7215. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Johnson, Benton Kurt can be contacted via phone (309) 269-3100.Contact Information
Primary practice address
2424 40Th Ave Apt 6
Moline IL 61265-7215
Phone: (309) 269-3100
Fax: (888) 243-3903
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 180006524 | Illinois |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 001063 | Iowa |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 180006524 | Illinois |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist | 222Q00000X | ||
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 180-006524 | Illinois |
Profile Details
NPI number | 1326264060 |
---|---|
LBN Legal business name | Johnson, Benton Kurt |
Credentials | PHD, LCPC, LMHC, NCC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 18th, 2007 |
Last updated | Jul 25th, 2021 - about 4 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 | 1326264060 | NPPES |
Illinois | Other | 208164344 | EI PROVIDER # |
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