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Basil Bennett
Peer Specialist in Logan, West Virginia
NPI 1821724543

Basil Bennett is a Peer Specialist based in Logan, WV. Basil Bennett practices in Logan, WV. The NPI Number for Basil Bennett is 1821724543 and holds a License No. 0072 (West Virginia).

The current practice location address for Basil Bennett is 174 Lmah Center Rd, Logan, WV and can be reached out via phone at 304-792-7130 and via fax at 304-896-5184. You can also correspond with Basil Bennett through the mailing address at PO BOX 176, LOGAN, WV - 25601-0176 (mailing address contact number: 304-792-7130).

Location: 174 Lmah Center Rd, Logan, WV, 25601-0176
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821724543
Provider Name
Basil Bennett
Credential
Provider Entity Type
Individual
Gender
Male
Address
174 Lmah Center Rd, Logan, WV, 25601-0176
Phone Number
304-792-7130
Fax Number
304-896-5184
Provider Enumeration Date
07/26/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
174 Lmah Center Rd
City
Logan
State
West Virginia
Zip
25601-4058
Phone Number
304-792-7130
Fax Number
304-896-5184
person
Provider Business Mailing Address Details
Address
174 Lmah Center Rd
City
Logan
State
West Virginia
Zip
25601-4058
Phone Number
304-792-7130
Fax Number
304-896-5184
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
0072 (West Virginia)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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