Organization
LENA BENNET LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MADELEINE BENNET LCSW (OWNER)
(505) 796-4210
Entity
Organization
Contact information
Practice address
6617 VOOSCANE AVE, COCHITI LAKE, NM 87083-6003
(505) 934-6558
Mailing address
PO BOX 1363, PENA BLANCA, NM 87041-1363
(505) 934-6558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76908551
—
NM
Enumeration date
06/22/2021
Last updated
11/30/2021
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