Marilyn Bennett, LMHC

Individual provider Active NPI Professional Counselor · Cocoa, FL

NPI 1295882736 · NPPES record last updated Sep 18, 2018

Key facts

NPI
1295882736
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
MH 7681 (FL)
Practice address
1 Oleander St Ste 3
Cocoa, FL 32922-7900
Phone
(321) 631-5538
Fax
(321) 631-5154
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MH 7681FLMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X FL
Professional Counselor 101YP2500X MH 7681 FL Yes

Addresses

Primary practice location

1 Oleander St Ste 3
Cocoa, FL 32922-7900

Mailing address

2593 S Park Ave
Titusville, FL 32780-5147
Phone (321) 631-5538

Other identifiers

IdentifierTypeStateIssuer
0764698 00MedicaidFL

Other providers in Cocoa, FL

All providers in Cocoa, FL · Professional Counselor in Florida

Sources for this page

Verify at the official NPI Registry.