NPI 1194835702 · live from the CMS NPI Registry
Randall E Bennett, LCPC,LMFT
Counselor, Professional in Aurora, IL. National Provider Identifier 1194835702, active.
NPI record
| NPI | 1194835702 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 2285 Sequoia Dr, Aurora, IL 60506 |
| Practice phone | 630-859-6700 |
| Mailing address | 2357 Sequoia Dr, Aurora, IL 60506 |
| Enumerated | August 30, 2006 |
| Last updated | July 14, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional primary | 101YP2500X | 180-002128 (IL) |
| Marriage & Family Therapist | 106H00000X | 166-000313 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.