Katie Bennett, | |
934 S Main St, Layton, UT 84041-7135 | |
(801) 336-1845 | |
Not Available |
Full Name | Katie Bennett |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 934 S Main St, Layton, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558827683 | NPI | - | NPPES |
260022408 | Other | UT | RAILROAD MEDICARE |
000055266 | Other | UT | MEDICARE PIN |
8760003008007 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 9582076-3501 (Utah) | Primary |
Entity Name | Renew Healthcare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548955479 PECOS PAC ID: 5698133726 Enrollment ID: O20230622001752 |
Mailing Address | Practice Location Address |
---|---|
Katie Bennett, 934 S Main St, Layton, UT 84041-7135 Ph: (801) 773-7060 | Katie Bennett, 934 S Main St, Layton, UT 84041-7135 Ph: (801) 336-1845 |
Kelley Diane Irmen, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Michele Tanner, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Jennifer Lynn Forbes, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Curtis M. Tesch, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Alison Coburn, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1660 W Antelope Dr Ste 320, Layton, UT 84041 Phone: 801-773-4840 | |
Brady D Olsen, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Rod F Thornley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 |