Provider Demographics
NPI:1669061776
Name:BENNETT, ARTHUR ALEXANDER III (LMFT)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:ALEXANDER
Last Name:BENNETT
Suffix:III
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 KING ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3151
Mailing Address - Country:US
Mailing Address - Phone:703-967-4157
Mailing Address - Fax:
Practice Address - Street 1:601 KING ST STE 302
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3151
Practice Address - Country:US
Practice Address - Phone:571-317-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001209106H00000X
CA22059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist