NPIMap

Individual provider Active NPI

Dawn P Kentish Bennett, MSW, LICSW

  • Clinical Social Worker
  • Stockbridge, GA
National Provider Identifier
1114258993
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02415 Issued in RI
Practice address
297 Ironwood Dr
Stockbridge, GA 30281-2287
Phone
(401) 743-0408
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW01380 RI
Social Worker 104100000X CSW01380 RI
Clinical Social Worker 1041C0700X ISW02415 RI Primary
Clinical Social Worker 1041C0700X CSW005849 GA

Addresses

Primary practice location

297 Ironwood Dr
Stockbridge, GA 30281-2287

Mailing address

297 Ironwood Dr
Stockbridge, GA 30281-2287
Phone (401) 743-0408

Other identifiers 1

IdentifierTypeStateIssuer
CSW01380OtherRILICENSE

Other names 1

  • Dawn P Kentish Bennett Professional name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005849GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1114258993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 IRONWOOD DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302812287",
            "telephone_number": "401-743-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 IRONWOOD DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302812287",
            "telephone_number": "401-743-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENTISH BENNETT",
        "first_name": "DAWN",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01380",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "RI",
            "license": "CSW01380",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02415",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005849",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CSW01380",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "KENTISH BENNETT",
            "middle_name": "P",
            "credential": "LCWS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.