Kenneth Peter Bennett, PHD
Individual provider Active NPI Clinical Psychologist · Fort Harrison, MT
NPI 1134840697 · NPPES record last updated Sep 2, 2022
Key facts
- NPI
- 1134840697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY-203704 (ID)
- Practice address
- 3687 Veterans Dr
Fort Harrison, MT 59636-9700 - Phone
- (406) 447-6000
- NPI assigned
- Sep 2, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-203704 | ID | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-203704 | ID | Yes |
Addresses
Primary practice location
3687 Veterans Dr
Fort Harrison, MT 59636-9700
Mailing address
3687 Veterans Dr # 169-183
Fort Harrison, MT 59636-9700
Phone (406) 447-6027
Other providers in Fort Harrison, MT
- Susan Ann Askin
- Rosanna Bailey
- Carolyn Barker
- Mary Kathleen Bartsch
- Nikki Batty
- Paul Edwin Berner
- Kyle Christopher Blackburn
- Veronica Blanton
- Mary G Blevins
- Kaylah Marie Boles
All providers in Fort Harrison, MT · Clinical Psychologist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.