Active NPI
Julia A Bennett, LCSW
- Clinical Social Worker
- Manchester, MO
National Provider Identifier
1285818286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149-011730
- Practice address
- 814 Conestoga Dr
Manchester, MO 63021-7510 - Phone
- (309) 256-7213
- Fax
- (309) 655-4609
- NPI assigned
- Dec 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149-011730 | IL | Primary |
Addresses
Primary practice location
814 Conestoga Dr
Manchester, MO 63021-7510
Mailing address
814 Conestoga Dr
Manchester, MO 63021-7510
Phone (130) 925-6721
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149-011730 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647043200000",
"number": "1285818286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 CONESTOGA DR",
"city": "MANCHESTER",
"state": "MO",
"postal_code": "630217510",
"telephone_number": "130-925-6721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 CONESTOGA DR",
"city": "MANCHESTER",
"state": "MO",
"postal_code": "630217510",
"telephone_number": "309-256-7213",
"fax_number": "309-655-4609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "JULIA",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-27",
"last_updated": "2022-03-12",
"certification_date": "2022-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149-011730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.