Individual
MR. JONATHAN ANTONIO BENNETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC-A
Contact information
Practice address
601 19TH AVE N # 202B, MYRTLE BEACH, SC 29577-3249
(843) 504-6912
(843) 326-4848
Mailing address
1909 CAPELLA CT, CONWAY, SC 29527-8200
(843) 450-4055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6918
SC
Other
Enumeration date
09/21/2018
Last updated
05/07/2026
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