Annette Jackson Benneche, LPC, M.S., M.ED.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

006255 Issued in GA

Practice address

110 N Main St
Greensboro, GA 30642-1108

Phone

(706) 453-7400

Fax

(855) 898-5414

NPI assigned

Jun 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education, Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serve, LLC

  • Professional Counselor
  • Hinesville, GA
  • NPI 1235688250
  NPD (past) Authorized official

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1831485523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 NORTH MAIN STREET",
            "address_2": "DBA: SERVE, LLC",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306423203",
            "telephone_number": "706-453-7400",
            "fax_number": "855-898-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306421108",
            "telephone_number": "706-453-7400",
            "fax_number": "855-898-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNECHE",
        "first_name": "ANNETTE",
        "middle_name": "JACKSON",
        "name_prefix": "Ms.",
        "credential": "LPC, M.S., M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "006255",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": "006255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12404855",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tania Lea Avolio, PT
• Richard W Baehler, MD
• Karen Marie Baker, FNP
• Andrew Bennett Bartolomei, MS, RDN
• Hannah M Baynes
• Benzer Pharmacy Ga1 LLC
• Timothy Eric Blackwell, PTA
• Tiffany T Blake
• Jennifer V Bowers, PA-C
• David Christopher Bradley, D.M.D.

• Professional Counselor in Greensboro, GA
• Providers in Greensboro, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.