Individual provider · Type 1 NPI

Samuel Richard Bennett

Mental Health Counselor · Chicago, IL

NPI number 1114536018 Active

Practice location

5214 N Western Ave
Chicago, IL 60625-2589

Mailing address

1465 Lake Dr
Morris, IL 60450-2405

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1114536018

Samuel Richard Bennett's National Provider Identifier is 1114536018, issued on Jul 27, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on Jul 27, 2020.