Individual provider Active NPI

Tonya Renee Bennett, LPCC

  • Professional Counselor
  • Glasgow, KY
National Provider Identifier
1124180666
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
102944 Issued in KY
Practice address
608 Happy Valley Rd
Glasgow, KY 42141-1561
Phone
(270) 901-5000
Fax
(270) 842-5268
NPI assigned
Dec 14, 2006
Sex
Female
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 enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102944KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills, Inc. PastSince Aug 27, 2015 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 102944 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

608 Happy Valley Rd
Glasgow, KY 42141-1561

Mailing address

380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
7100288280MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 11, 2017.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1124180666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUWANNEE TRAIL ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037956",
            "telephone_number": "270-901-5000",
            "fax_number": "270-842-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 HAPPY VALLEY RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411561",
            "telephone_number": "270-901-5000",
            "fax_number": "270-842-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TONYA",
        "middle_name": "RENEE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "102944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100288280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.