Provider Demographics
NPI:1699902494
Name:BENNETT, LINDSAY KATHRYN (BSW, MHPP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:KATHRYN
Last Name:BENNETT
Suffix:
Gender:F
Credentials:BSW, MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VILONIA
Mailing Address - State:AR
Mailing Address - Zip Code:72173-9524
Mailing Address - Country:US
Mailing Address - Phone:501-772-9278
Mailing Address - Fax:
Practice Address - Street 1:1112 MAIN ST
Practice Address - Street 2:
Practice Address - City:VILONIA
Practice Address - State:AR
Practice Address - Zip Code:72173-9524
Practice Address - Country:US
Practice Address - Phone:501-772-9278
Practice Address - Fax:501-982-5007
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist