Audrey L Bennett, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006194 Issued in CT

Practice address

8901 Wisconsin Ave
Bethesda, MD 20889-5001

Phone

(860) 819-8570

Fax

(301) 319-8630

NPI assigned

Aug 30, 2006

Last updated

Jan 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Audrey L Scoville Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Weave Your Life LLC

  • Clinical Social Worker
  • Southington, CT
  • NPI 1104149293
  Authorized official Same address or phone
• Bristol Hospital Multi-Specialty Group, Inc.

  • Psychiatry Physician
  • Bristol, CT
  • NPI 1396734109

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1093824294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895600",
            "telephone_number": "301-400-1295",
            "fax_number": "301-319-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895001",
            "telephone_number": "860-819-8570",
            "fax_number": "301-319-8630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95-1184 Makaikai St Apt 55",
            "address_purpose": "LOCATION",
            "city": "Mililani",
            "state": "HI",
            "postal_code": "967895342",
            "country_code": "US",
            "telephone_number": "860-819-8570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "AUDREY",
        "middle_name": "L",
        "credential": "LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000729",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "006194",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004262945",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006194",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "SCOVILLE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cristina Benito, OT
• Marko Benito
• John Robert Benjamin, M.D.
• Rohit Ninan Benjamin, MD
• Alexandra Clarisa Bennett, O.D
• Brad Bennett, DMD
• Carmine Bennett
• Donald Richard Bennett, M.D.
• Howard J. Bennett, M.D.
• Jason Winslow Bennett, M.D., M.S.P.H.

• Clinical Social Worker in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.