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Individual

TERESEA L BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW, LCAC

Contact information

Practice address
2501 E 13TH, BUILDING 3 SUITE 10, HAYS, KS 67601
(785) 628-3573
(785) 621-2257
Mailing address
1917 MONROE ST, ELLIS, KS 67637-1905
(785) 623-3482

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
103
KS
104100000X
Social Worker
Primary
10020
KS

Other

Enumeration date
08/16/2018
Last updated
08/16/2018
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