Individual
ADRIANE G BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6575 STRATHMORE DR, CLEVELAND, OH 44125
(440) 668-7772
Mailing address
PO BOX 660, MENTOR, OH 44061-0660
(440) 854-0217
(440) 516-3783
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P.6761
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP NPI GROUP #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
05
—
3136814
—
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE PTAN
OH
Enumeration date
01/24/2011
Last updated
04/30/2024
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