Individual
VIRGINIA ELIZABETH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW; LCADC
Contact information
Practice address
100 W 3RD ST STE 304, OWENSBORO, KY 42303-4129
(270) 315-1443
(270) 228-0341
Mailing address
100 W 3RD ST STE 304, OWENSBORO, KY 42303-4129
(270) 315-1443
(270) 228-0341
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
ADCLAD00225431
KY
104100000X
Social Worker
6120
KY
1041C0700X
Clinical Social Worker
Primary
252610
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100412450
—
KY
01
—
K236700
MEDICARE
KY
Enumeration date
01/28/2015
Last updated
03/17/2018
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