Mary Kathryn Bennett, M.A., L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Ada, MI
NPI 1265768097 · NPPES record last updated Oct 29, 2009
Key facts
- NPI
- 1265768097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW6801065404 (MI)
- Practice address
- 983 Spaulding Ave. S.E.
Ada, MI 49301 - Phone
- (616) 942-9000
- Fax
- (616) 942-0008
- NPI assigned
- Oct 29, 2009
- Sex
- Female
- 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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW6801065404 | MI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW6801065404 | MI | Yes |
Addresses
Primary practice location
983 Spaulding Ave. S.E.
Ada, MI 49301
Mailing address
983 Spaulding Ave. S.E.
Ada, MI 49301
Phone (616) 942-9000
Other providers in Ada, MI
- Lara Jean Baatenburg
- Jason E Baniukaitis
- Ashley Barcroft
- Alexa Marie Bates
- Amy Renae Bell
- Madison Victoria Berridge
- Bethany Sluiter Counseling, LLC Dba Grove Collaborative Counseling
- James Douglas Birmingham
- Andrew J Boekestein
- Julia Bos
All providers in Ada, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2009. 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.