Trevon Bennett, BSW, MSW
Individual provider Active NPI Social Worker · Copley, OH
NPI 1699245357 · NPPES record last updated Feb 21, 2022
Key facts
- NPI
- 1699245357
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.1904067 (OH)
- Practice address
- 3801 Fairway Park Dr Apt 201
Copley, OH 44321-2997 - Phone
- (330) 414-6302
- NPI assigned
- Nov 26, 2018
- Sex
- Male
- 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 |
|---|---|---|---|
| S.1904067 | OH | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | S.1904067 | OH | |
| Social Worker | 104100000X | S.1904067 | OH | Yes |
Addresses
Primary practice location
3801 Fairway Park Dr Apt 201
Copley, OH 44321-2997
Mailing address
3801 Fairway Park Dr Apt 201
Copley, OH 44321-2997
Phone (330) 414-6302
Other providers in Copley, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2022. 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.