Christan Latonya Bennett, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13712 Issued in FL

Practice address

1589 Mountain Lake Dr E
Jacksonville, FL 32221-5548

Phone

(904) 337-9073

Fax

(904) 337-4448

NPI assigned

Feb 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Christan Latonya Bennett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
  • NPI 1053970194
  NPD
• Empowered Sol Wellness Center, LLC

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1124689880
  NPD (past)
• River's Edge Counseling, PLLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1548958168

  Clinical

  NPD (past)

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732406400000",
    "number": "1114266731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 MOUNTAIN LAKE DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322215548",
            "telephone_number": "904-337-9073",
            "fax_number": "904-337-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 MOUNTAIN LAKE DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322215548",
            "telephone_number": "904-337-9073",
            "fax_number": "904-337-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CHRISTAN",
        "middle_name": "LATONYA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "160994624",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029573621",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTAN",
            "last_name": "BENNETT",
            "middle_name": "LATONYA",
            "prefix": "MS.",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aleta Bennett
• Amanda Lynn Bennett
• Brett Rigell Bennett, MSW
• Brookelin J Bennett
• Cassandra L Bennett
• Cindy N Bennett, ATC
• Dejoris Bennett
• Flordeliza L Bennett
• Itzel Maria Bennett
• James Brandon Bennett, DMD

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; 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.