Kenneth Alvin Bennett Jr., LCSW, CART

Individual provider Active NPI Clinical Social Worker · Euless, TX

NPI 1023150901 · NPPES record last updated Oct 29, 2024

Key facts

NPI
1023150901
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
50547 (TX)
Practice address
610 S Industrial Blvd
Suite 307
Euless, TX 76040-5048
Phone
(817) 917-2335
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
50547TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Midcities Center for Change, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 50547 TX Yes

Addresses

Primary practice location

610 S Industrial Blvd
Suite 307
Euless, TX 76040-5048

Mailing address

610 S Industrial Blvd
307
Euless, TX 76040-5048
Phone (817) 917-2335

Other providers in Euless, TX

All providers in Euless, TX · Clinical Social Worker in Texas

Sources for this page

Verify at the official NPI Registry.