| Lena Bennet Lcsw Llc | |
|
6617 Vooscane Ave Cochiti Lake NM 87083-6003 | |
| (505) 934-6558 | |
| Not Available |
| Full Name | Lena Bennet Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6617 Vooscane Ave, Cochiti Lake, New Mexico |
| Authorized Official Name and Position | Madeleine Bennet (OWNER) |
| Authorized Official Contact | 5057964210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lena Bennet Lcsw Llc Po Box 1363 Pena Blanca NM 87041-1363 Ph: (505) 934-6558 | Lena Bennet Lcsw Llc 6617 Vooscane Ave Cochiti Lake NM 87083-6003 Ph: (505) 934-6558 |
| NPI Number | 1588233761 |
|---|---|
| Provider Enumeration Date | 06/22/2021 |
| Last Update Date | 11/30/2021 |
| Certification Date | 11/30/2021 |
| Medicare PECOS PAC ID | 3274923107 |
|---|---|
| Medicare Enrollment ID | O20211208000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588233761 | NPI | - | NPPES |
| 76908551 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Madeleine Bennet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629459813 PECOS PAC ID: 4183014012 Enrollment ID: I20220121000506 |
National Latino Behavioral Health Association Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6555 Robin St, Cochiti Lake, NM 87083 Phone: 505-980-5156 |