Provider Demographics
NPI:1447876099
Name:BENNETT, SHAWNTE F (ALMFT)
Entity type:Individual
Prefix:
First Name:SHAWNTE
Middle Name:F
Last Name:BENNETT
Suffix:
Gender:F
Credentials:ALMFT
Other - Prefix:
Other - First Name:SHAWNTA
Other - Middle Name:F
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN AVE STE 809
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3776
Mailing Address - Country:US
Mailing Address - Phone:312-767-2057
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-767-2057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist