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Individual
MR. RONALD WAYNE BENNETT
Active
Individual
MR. RONALD WAYNE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932319
BLUE CROSS BLUE SHIELD
IL
01
—
192753
VALUEOPTIONS
IL
01
—
244552
COMPSYCH
IL
Enumeration date
11/28/2006
Last updated
07/08/2007
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