# BENNETT CREEK THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720793482
- **Authorized official:** ANJANETTE TUCKMAN LCSW (OWNER)
- **Authorized official phone:** (541) 556-4606

## Contact information

- **Practice address:** 650 BENNETT CREEK RD, COTTAGE GROVE, OR 97424-1007
- **Practice address phone:** (541) 556-4606
- **Practice address fax:** (541) 403-9893
- **Mailing address:** 650 BENNETT CREEK RD, COTTAGE GROVE, OR 97424-1007
- **Mailing address phone:** (541) 556-4606
- **Mailing address fax:** (541) 403-9893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2023
- **Last updated:** 01/17/2023