Individual
DR. BENNETT EDGERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LPC
Contact information
Practice address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0016208
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-15634
ARIZONA LICENSE
AZ
01
—
LPC.0016208
STATE LICENSING BOARD OF COLORADO
CO
Enumeration date
08/08/2017
Last updated
07/25/2023
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