Charlene G Bennett, LCSW
Individual provider Active NPI Clinical Social Worker · Lake Wales, FL
NPI 1669730495 · NPPES record last updated Apr 30, 2012
Key facts
- NPI
- 1669730495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW593 (FL)
- Practice address
- 929 Carlton Ave
Lake Wales, FL 33853-4238 - Phone
- (863) 676-9231
- NPI assigned
- Apr 30, 2012
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW593 | FL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW593 | FL | Yes |
Addresses
Primary practice location
929 Carlton Ave
Lake Wales, FL 33853-4238
Mailing address
929 Carlton Ave
Lake Wales, FL 33853-4238
Phone (863) 676-9231
Other providers in Lake Wales, FL
- Jennifer Bayron
- Randall D Beck
- Brianna Tykia Bell
- Thomas J Bell
- Jaquenetta Williams Bennertt
- Stephanie Ann Benton
- Jeffrey Berdahl
- Julia Hunt Berkau
- Best Value Healthcare
- Misty Bittner
All providers in Lake Wales, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2012. 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.