| Samantha Bennett Lcsw Therapy Llc | |
|
918 Ne 5th St Bend OR 97701-4617 | |
| (541) 771-8170 | |
| Not Available |
| Full Name | Samantha Bennett Lcsw Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 918 Ne 5th St, Bend, Oregon |
| Authorized Official Name and Position | Samantha L Bennett (OWNER) |
| Authorized Official Contact | 5417718170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samantha Bennett Lcsw Therapy Llc 70 Sw Century Dr Ste 100 Bend OR 97702-3558 Ph: (541) 771-8170 | Samantha Bennett Lcsw Therapy Llc 918 Ne 5th St Bend OR 97701-4617 Ph: (541) 771-8170 |
| NPI Number | 1184344533 |
|---|---|
| Provider Enumeration Date | 08/29/2022 |
| Last Update Date | 10/03/2022 |
| Certification Date | 10/03/2022 |
| Medicare PECOS PAC ID | 5395117568 |
|---|---|
| Medicare Enrollment ID | O20230216001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184344533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Samantha L Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124253950 PECOS PAC ID: 1951538354 Enrollment ID: I20131210001276 |
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