Individual provider Active NPI

Caitlyn McKinzie Bennett, PH.D., LMHC, LMFT, L

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1649931791
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15032 Issued in FL
Practice address
3023 Harrison Ave
Orlando, FL 32804-3731
Phone
(850) 625-1026
NPI assigned
Dec 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 4120 FL
Mental Health Counselor 101YM0800X 15032 FL Primary

Addresses

Primary practice location

3023 Harrison Ave
Orlando, FL 32804-3731

Mailing address

3023 Harrison Ave
Orlando, FL 32804-3731
Phone (850) 625-1026

Other practice location 1

1280 Palmetto Ave
Winter Park, FL 32789-4950
Phone (321) 348-7833

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4120FLMDMarriage & Family Therapist
15032FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1649931791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 HARRISON AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328043731",
            "telephone_number": "850-625-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HARRISON AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328043731",
            "telephone_number": "850-625-1026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 Palmetto Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327894950",
            "country_code": "US",
            "telephone_number": "321-348-7833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CAITLYN",
        "middle_name": "MCKINZIE",
        "credential": "PH.D., LMHC, LMFT, L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "4120",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "15032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.