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Individual
MRS. TERESA ANNE COOLEY BENNETT
Active
Individual
MRS. TERESA ANNE COOLEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LSCSW, CCDP-D
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2000164407
MO
1041C0700X
Clinical Social Worker
LSCSW 3852
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000C334
MEDICARE PROVIDER ID #
—
05
—
200579670A
—
KS
05
—
495372203
—
MO
Enumeration date
02/27/2007
Last updated
08/27/2026
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