Individual provider Active NPI

Gregory James Bennett, LAT

  • Addiction (Substance Use Disorder) Counselor
  • Powell, WY
National Provider Identifier
1194034454
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LAT326 Issued in WY
Practice address
249 E 2ND St Ste 1
Powell, WY 82435-1959
Phone
(307) 254-2038
NPI assigned
Oct 4, 2010
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LAT326 WY Primary

Addresses

Primary practice location

249 E 2ND St Ste 1
Powell, WY 82435-1959

Mailing address

1051 Morning Glory LN
Powell, WY 82435-2266
Phone (307) 254-2038

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
LAT326WYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Ridge Counseling LLC Addiction (Substance Use Disorder) CurrentSince Oct 27, 2024 Accepting new patients

Locations

1901 Energy Ct
Ste 170
Gillette, WY 82718
Phone (307) 254-0007

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

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1194034454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 MORNING GLORY LN",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352266",
            "telephone_number": "307-254-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 E 2ND ST STE 1",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824351959",
            "telephone_number": "307-254-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-04",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "LAT326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.