Individual provider Active NPI

Courtney M Bennett, LPC

  • Professional Counselor
  • Hampton, VA
National Provider Identifier
1760012124
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701008884 Issued in VA
Practice address
2202 Executive Dr Ste C
Hampton, VA 23666-6604
Phone
(757) 877-7077
Fax
(757) 838-2573
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701008884 VA Primary

Addresses

Primary practice location

2202 Executive Dr Ste C
Hampton, VA 23666-6604

Mailing address

2202 Executive Dr Ste C
Hampton, VA 23666-6604
Phone (757) 877-7077

Other names 1

  • Courtney White Former name

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

State licenses

LicenseStateTypeSpecialty
0701008884VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1760012124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR STE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-877-7077",
            "fax_number": "757-838-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR STE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-877-7077",
            "fax_number": "757-838-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "COURTNEY",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "WHITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.