Active NPI
Mary J Crosby Bennett, LCSW
- Clinical Social Worker
- Rancho Cucamonga, CA
National Provider Identifier
1891829925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS12996
- Practice address
- 8580 Utica Ave
Ste 200
Rancho Cucamonga, CA 91730 - Phone
- (909) 944-1717
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- 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 | LCS12996 | CA | Primary |
Addresses
Primary practice location
8580 Utica Ave
Ste 200
Rancho Cucamonga, CA 91730
Mailing address
8580 Utica Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 944-1717
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS12996 | CA | MD | Clinical Social Worker |
| 12996 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891829925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8580 UTICA AVE",
"address_2": "STE 200",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "91730",
"telephone_number": "909-944-1717",
"fax_number": "909-948-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8580 UTICA AVE",
"address_2": "STE 200",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "91730",
"telephone_number": "909-944-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSBY BENNETT",
"first_name": "MARY",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS12996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.