Lorraine Bennett, TLLP, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401020248 Issued in MI

Practice address

2180 44TH St SE Ste 301
Grand Rapids, MI 49508-5093

Phone

(616) 259-5112

Fax

(616) 971-6157

NPI assigned

Jul 11, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dusty Lorraine Pittman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Life Without Flaws

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1831819143
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1023660891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6054 IN THE PINES DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495488503",
            "telephone_number": "616-432-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 44TH ST SE STE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495085093",
            "telephone_number": "616-259-5112",
            "fax_number": "616-971-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LORRAINE",
        "credential": "TLLP, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401020248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DUSTY",
            "last_name": "PITTMAN",
            "middle_name": "LORRAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grace Elizabeth Bennett
• Gregor F Bennett, PA
• Jason B. Bennett, M.D.
• Jordan A Bennett, MSW
• Laura Lee Bennett, MA., LLP
• Michael L Bennett, M.D.
• Nikol Bennett
• Peggy Bennett, RN
• Sejal Patel Bennett, MD
• Shawna Bennett, LLPC, LLMFT

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.