DR. JEANNE MARIE BENNETT (NPI# 1164429320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164429320 |
| Entity Type | Individual |
| Full Name | DR. JEANNE MARIE BENNETT |
| Credential | PSY.D. |
| Practice Address |
1169 Eastern Pkwy Ste 2238 Louisville KY 40217-1444 |
| Mailing Address |
9012 Willow Springs Drive Louisville KY 40242-7763 |
| Practice Telephone | 5023767552 |
| Practice Fax Number | 5024255540 |
| Mailing Telephone | 5023767552 |
| Mailing Fax Number | 5024255540 |
| Enumeration Date | 2005-07-02 |
| Last Update Date | 2017-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 129055 | KY | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | 1034 | KY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
1034 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM | 000000376778 | 01 |
| KY | 89000061 | 05 | |
| KY | AETNA | 7020285 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023345766 | Jeanne Ellen Bennett | Specialist | 2640 W 89th Pl, Evergreen Park, IL 60805-1302 | 2009-11-16 |
| Street Address |
1169 EASTERN PKWY STE 2238 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40217-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760795066 | Dawn Skees | Dentist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2010-07-15 |
| 1790955334 | J Bennett Group Psc | Clinical Neuropsychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2008-03-11 |
| 1184649402 | Dennis E Wagner | Psychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720564016 | Kaela Marie Turley | Nurse Practitioner | 2355 Poplar Level Rd Ste 405, Louisville, KY 40217 | 2018-07-19 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1386185437 | Meredith Brooke Ervin | Counselor | 1169 Eastern Pkwy Ste 3310, Louisville, KY 40217 | 2017-03-08 |
| 1437507621 | Kendra Pickerill | Speech-Language Pathologist | 906 Delor Avenue, Louisville, KY 40217 | 2016-05-27 |
| 1275947186 | Gary Muncy | Massage Therapist | 607 East Brandeis Ave, Louisville, KY 40217 | 2014-06-18 |
| 1912318791 | Stacey Charlotte Elmes | Case Manager/Care Coordinator | 2338 Alexanderave, Louisville, KY 40217 | 2014-05-14 |
| 1275819831 | April Mecasha Cox | Pharmacist | 808 Eastern Parkway, Louisville, KY 40217 | 2011-10-27 |
| 1831346204 | Nikki Renee Wilson | Registered Nurse | 1169 Eastern Pkwy Ste 1226, Louisville, KY 40217 | 2008-08-27 |
| 1497925440 | Sarah Beth Murrow | Chiropractor | 1100 Milton St, Louisville, KY 40217 | 2008-03-06 |
| 1457560302 | Ferenc Pantaleone Nagy | Surgery | 3 Audubon Plaza Dr Ste 220, Louisville, KY 40217 | 2007-05-21 |
| Find all providers in zip 40217 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437393170 | Bradley Scott Folley | Clinical Neuropsychologist | 4950 Norton Healthcare Blvd Ste 205, Louisville, KY 40241-2847 | 2009-04-24 |
| 1265689475 | Marilyn M. Wagner Ph.d., Psc | Clinical Neuropsychologist | 105a Crescent Ave, Louisville, KY 40206-1525 | 2008-08-20 |
| 1073704011 | Jennifer A Geiger | Clinical Neuropsychologist | 275 Century Cir Ste 203, Louisville, CO 80027-9453 | 2007-08-06 |
| 1619186467 | James Frederick Phifer | Clinical Neuropsychologist | 440 Breckenridge Lane Ste 124, Louisville, KY 40218 | 2007-05-21 |
| 1508916958 | Michael H Cecil | Clinical Neuropsychologist | 13293 Obannon Station Way, Louisville, KY 40223-4188 | 2007-01-10 |
| 1396763249 | Jacquelyn J. Graven | Clinical Neuropsychologist | 421 Benjamin Lane, Ste 202, Louisville, KY 40222 | 2006-07-18 |
| 1154301356 | Donald Bradley Burton | Clinical Neuropsychologist | 4200 Browns Ln, Louisville, KY 40220-1523 | 2006-01-23 |
| 1356333090 | Melissa A Boyles | Clinical Neuropsychologist | 2915 Frankfort Ave, Suite E, Louisville, KY 40206-2682 | 2005-08-18 |
| 1518968205 | Richard I Edelson | Clinical Neuropsychologist | 7511 New Lagrange Rd, Louisville, KY 40222-4859 | 2005-08-03 |
| 1174520530 | Dennis Buchholz | Clinical Neuropsychologist | 1161 E Broadway, Louisville, KY 40204-1711 | 2005-06-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40217 |
Please comment or provide details below to improve the information on DR. JEANNE MARIE BENNETT.
| 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.