GLEN BENNETT (NPI# 1295195568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295195568 |
| Entity Type | Individual |
| Full Name | GLEN BENNETT |
| Credential | LAPC |
| Practice Address |
304 Pierce Ave Macon GA 31204-2422 |
| Practice Telephone | 4043149752 |
| Mailing Telephone | 4043149752 |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
APC005038 | GA | Behavioral Health & Social Service Providers |
| Street Address |
304 PIERCE AVE |
| City | MACON |
| State | GA |
| Zip Code | 31204-2422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568524882 | Methodist Home of The South Ga Conference | Community/Behavioral Health | 304 Pierce Ave, Macon, GA 31204-2422 | 2006-12-14 |
| 1073916235 | Ellen Thomas | Marriage & Family Therapist | 304 Pierce Ave, Macon, GA 31204-2422 | 2014-10-02 |
| 1942600630 | Vernisa' Ashley | Counselor | 304 Pierce Ave, Macon, GA 31204-2422 | 2014-08-29 |
| 1023378239 | Mary Angie Mcgukin | Counselor | 304 Pierce Ave, Macon, GA 31204-2422 | 2012-05-22 |
| 1750548079 | Carolyn Dailey | Registered Nurse | 304 Pierce Ave, Macon, GA 31204-2422 | 2008-05-22 |
| 1821255159 | Keshia Moore | Registered Nurse | 304 Pierce Ave, Macon, GA 31204-2422 | 2008-05-22 |
| 1083871313 | Debra Deignan | Registered Nurse | 304 Pierce Ave, Macon, GA 31204-2422 | 2008-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518445014 | Enhance Behavioral Health, LLC | Counselor | 3083 Vineville Ave, Macon, GA 31204-2460 | 2018-08-06 |
| 1588153621 | Efcel Aaron Velez | Counselor | 544 Mulberry St Ste 305, Macon, GA 31201-8284 | 2018-05-03 |
| 1275021396 | Tanisha Andrea Primas | Counselor | 560 Oglethorpe St, Macon, GA 31201-6842 | 2018-04-24 |
| 1265946974 | Ervin N/a Briones | Counselor | 1552 Long Acre Dr, Macon, GA 31204-4924 | 2017-11-17 |
| 1760928386 | Amelia Barton | Counselor | 139 Kimmeridge Dr, Macon, GA 31220-2681 | 2017-01-07 |
| 1528519741 | Yanci Lavender | Counselor | 43 Mlk Dr, Macon, MS 39341-2734 | 2016-10-24 |
| 1639543259 | Imani Shaw | Counselor | 3985 Arkwright Rd Ste 106, Macon, GA 31210-1775 | 2015-11-19 |
| 1548669252 | Diane Hairston | Counselor | 43 W Martin Luther King Dr, Macon, MS 39741 | 2014-08-19 |
| 1487084323 | Tamara Epps | Counselor | 2313 Lowe St, Macon, GA 31206-3145 | 2013-11-13 |
| 1679849921 | Rasheedah Atiyah Bankhead | Counselor | 43 Dr Martin Luther King Jr Dr, Macon, MS 39341-2734 | 2012-03-30 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.