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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1326264060 NPPES
Illinois Other 208164344 EI PROVIDER #

Popular Providers