Active NPI
Ronald Wayne Bennett, LCPC
- Mental Health Counselor
- Frankfort, IL
National Provider Identifier
1982770103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 809 Overlook Dr
Frankfort, IL 60423-1053 - Phone
- (815) 351-2299
- Fax
- (815) 469-9202
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IL | Primary |
Addresses
Primary practice location
809 Overlook Dr
Frankfort, IL 60423-1053
Mailing address
809 Overlook Dr
Frankfort, IL 60423-1053
Phone (815) 351-2299
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 244552 | Other | IL | COMPSYCH |
| 192753 | Other | IL | VALUEOPTIONS |
| 09932319 | Other | IL | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 180-002556 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982770103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 OVERLOOK DR",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604231053",
"telephone_number": "815-351-2299",
"fax_number": "815-469-9202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 OVERLOOK DR",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604231053",
"telephone_number": "815-351-2299",
"fax_number": "815-469-9202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "RONALD",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "244552",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "192753",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "09932319",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Frankfort, IL
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.