Kelly Randolph Bennett, PHD - Psychologist in Santa Fe, NM

Kelly Randolph Bennett, PHD is a Psychologist - Counseling based in Santa Fe, New Mexico. Kelly Randolph Bennett is licensed to practice in New Mexico (license number LPCC 0088061) and his current practice location is 578 Via Arista, Santa Fe, New Mexico. He can be reached at his office (for appointments etc.) via phone at (505) 577-1862.

NPI number for Kelly Randolph Bennett is 1134302722 and his current mailing address is Po Box 9880, Santa Fe, New Mexico. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1134302722.

Contact Information

Kelly Randolph Bennett, PHD
578 Via Arista,
Santa Fe, NM 87506-4507
(505) 577-1862
(505) 466-9459

Map and Direction




Healthcare Provider's Profile

Full NameKelly Randolph Bennett
GenderMale
SpecialityPsychologist - Counseling
Location578 Via Arista, Santa Fe, New Mexico
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1134302722
  • Provider Enumeration Date: 12/06/2007
  • Last Update Date: 04/07/2008

Medical Identifiers

Medical identifiers for Kelly Randolph Bennett such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134302722NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC1900XPsychologist - Counseling LPCC 0088061 (New Mexico)Primary
103TC1900XPsychologist - Counseling MFC 2017 (California)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Randolph Bennett is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly Randolph Bennett, PHD
Po Box 9880,
Santa Fe, NM 87504-9880

Ph: (505) 577-1862
Kelly Randolph Bennett, PHD
578 Via Arista,
Santa Fe, NM 87506-4507

Ph: (505) 577-1862

Reviews and Comments


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