Provider Demographics
NPI:1487496840
Name:BENNETT HESTER, WENDELL
Entity type:Individual
Prefix:
First Name:WENDELL
Middle Name:
Last Name:BENNETT HESTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 MARTIN LUTHER KING JR AVE SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4933
Mailing Address - Country:US
Mailing Address - Phone:202-318-0179
Mailing Address - Fax:
Practice Address - Street 1:15391 BASSFORD RD
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-4358
Practice Address - Country:US
Practice Address - Phone:240-432-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional