Provider Demographics
NPI:1528646486
Name:BENNETT, MARGARET NEWBERRY DRAKE (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:NEWBERRY DRAKE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:121 TOWNE ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 TOWNE ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5930
Practice Address - Country:US
Practice Address - Phone:203-803-7165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-03-15
Deactivation Date:2021-04-01
Deactivation Code:
Reactivation Date:2021-05-06
Provider Licenses
StateLicense IDTaxonomies
NY0972111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical