| Betsy Bennett, Llc | |
|
813 W South St Kalamazoo MI 49007-4696 | |
| (269) 303-2302 | |
| Not Available |
| Full Name | Betsy Bennett, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 813 W South St, Kalamazoo, Michigan |
| Authorized Official Name and Position | Betsy Bennett (OWNER) |
| Authorized Official Contact | 2693032302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Betsy Bennett, Llc 218 1/2 Woodward Ave Kalamazoo MI 49007-3222 Ph: (269) 303-2302 | Betsy Bennett, Llc 813 W South St Kalamazoo MI 49007-4696 Ph: (269) 303-2302 |
| NPI Number | 1700306503 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 06/22/2017 |
| Medicare PECOS PAC ID | 4789958919 |
|---|---|
| Medicare Enrollment ID | O20170926003729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700306503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801093831 (Michigan) | Primary |
| Provider Name | Elizabeth Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053851493 PECOS PAC ID: 6507130739 Enrollment ID: I20170929000241 |
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