Courtney Paul Bennett Jr.

Individual provider Active NPI Case Manager/Care Coordinator · Dedham, MA

NPI 1457697302 · NPPES record last updated Dec 21, 2012

Key facts

NPI
1457697302
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
280 Bridge St
Ste 230
Dedham, MA 02026-1759
Phone
(781) 320-7607
Fax
(781) 326-4654
NPI assigned
Dec 21, 2012
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Mentor LLC Past Accepting new patients
National Mentor Healthcare, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

280 Bridge St
Ste 230
Dedham, MA 02026-1759

Mailing address

280 Bridge St
Ste 230
Dedham, MA 02026-1759
Phone (781) 320-7607

Other providers in Dedham, MA

All providers in Dedham, MA · Case Manager/Care Coordinator in Massachusetts

Sources for this page

Verify at the official NPI Registry.