Individual
KEVIN DONNELL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
401 E HUNTING PARK AVE, PHILADELPHIA, PA 19124-6008
(215) 427-4750
(215) 425-3688
Mailing address
1137 E MOUNT PLEASANT AVE, PHILADELPHIA, PA 19150-2901
(267) 273-5899
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW020511
PA
Other
Enumeration date
03/17/2022
Last updated
03/17/2022
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