Individual
JESSICA BENAVIDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(505) 425-6788
(505) 747-7396
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
X-11743
NM
104100000X
Social Worker
Primary
M-11870
—
Other
Enumeration date
12/11/2020
Last updated
06/25/2024
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