Marlo Kathleen Bennett, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

357426-3902 Issued in UT

Practice address

1901 Prospector Ave Ste 22
Park City, UT 84060-7208

Phone

(435) 901-3218

NPI assigned

Jan 27, 2006

Last updated

Aug 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Marlo Bennett Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1720059819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 PROSPECTOR AVENUE",
            "address_2": "STE 22",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84060",
            "telephone_number": "435-901-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 PROSPECTOR AVE STE 22",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607208",
            "telephone_number": "435-901-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARLO",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "357426-3902",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "357426-3902",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "357426-3902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLO",
            "last_name": "BENNETT",
            "prefix": "MS.",
            "credential": "LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristina Coleman Beaver, P.T.
• Jennifer Beck-Schmidt, DC, RN
• Beehive Homes of Park City
• Elise Amelia Begg, PT, DPT
• Ellen Behrens, PH.D.
• Aaron Bennion, F.N.P.
• Jaime Bercuson, M.A., PSY.D.
• Joseph H Berman, MD
• Nichole Bernhard, O.T.R.
• Cynthia C Berwald, PA

• Mental Health Counselor in Park City, UT
• Providers in Park City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.