Bennett, Katie

Bennett, Katie is an sole proprietor health care provider with primary practice located at 4933 S 1500 W Ste 200 , Riverdale UT 84405-7738. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bennett, Katie can be contacted via phone (801) 510-8676.

Contact Information

Primary practice address
4933 S 1500 W Ste 200 Riverdale UT 84405-7738
Phone: (801) 510-8676
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 9582076-3501 Utah
Behavioral Health & Social Service Providers / Clinical 1041C0700X 9582076-3501 Utah

Profile Details

NPI number 1558827683
LBN Legal business name Bennett, Katie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2019
Last updated Dec 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558827683 NPPES
Utah MEDICAID 8760003008007
Utah Other 260022408
Utah Other 000055266

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