MS. PENNY MAIN-BENNETT LADC NPI 1780710442

NPI Information

  • NPI: 1780710442
  • Provider Name: MS. PENNY MAIN-BENNETT, LADC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 16525 HIGHWAY 65 NE
    HAM LAKE X, MN
    ZIP 55304
  • Phone: (763) 413-8838

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NPI Details

MS. Penny Main-bennett, LADC is an addiction (substance use disorder) counselor in Ham Lake X, MN. MS. Penny Main-bennett, LADC NPI is 1780710442. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

16525 HIGHWAY 65 NE
HAM LAKE X, MN
ZIP 55304-300
Phone: (763) 413-8838
Fax: (763) 413-8878

The enumeration date for this NPI number is 2/26/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)300832MINNESOTANo
2101YA0400XCounselorAddiction (Substance Use Disorder)1010135-1-CDTMINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11030158OTHERMINNESOTAPREFERRED ONE
26C74GROTHERMINNESOTABCBS OF MN
35040353OTHERMINNESOTAUBH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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