Richard Bennink, LCSW

Individual provider Active NPI Clinical Social Worker · Uncasville, CT

NPI 1710168679 · NPPES record last updated Nov 20, 2007

Key facts

NPI
1710168679
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
001206 (CT)
Practice address
5 Crow Hill Rd
Uncasville, CT 06382-1118
Phone
(860) 862-6235
NPI assigned
Nov 20, 2007
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

LicenseStateTypeSpecialty
001206CTMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 001206 CT Yes

Addresses

Primary practice location

5 Crow Hill Rd
Uncasville, CT 06382-1118

Mailing address

5 Crow Hill Rd
Uncasville, CT 06382-1118
Phone (860) 862-6235

Other providers in Uncasville, CT

All providers in Uncasville, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.