Active NPI
Robert B Bennett, DSW, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1871736033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34003463
- Practice address
- 5401 Shelby St
Indianapolis, IN 46227-4216 - Phone
- (317) 788-4451
- NPI assigned
- Apr 16, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34003463 | IN | Primary |
Addresses
Primary practice location
5401 Shelby St
Indianapolis, IN 46227-4216
Mailing address
5401 Shelby St
Indianapolis, IN 46227-4216
Phone (317) 788-4451
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34003463 | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southside Youth Council, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Indianapolis, IN
- NPI 1003994245
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239840000000",
"number": "1871736033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 SHELBY ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462274216",
"telephone_number": "317-788-4451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 SHELBY ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462274216",
"telephone_number": "317-788-4451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "ROBERT",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DSW, LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-16",
"last_updated": "2009-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34003463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.