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Individual

KATHERINE SUE BENNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4920 E MILLRIDGE PARKWAY, SUITE 220, RICHMOND, VA 23112
(804) 622-5350
(804) 622-5350
Mailing address
4920 E MILLRIDGE PARKWAY, SUITE 220, RICHMOND, VA 23112
(804) 622-5350
(804) 622-5350

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17731015
AETNA PROVIDER NUMBER
VA
01
289622
ANTHEM
VA
01
341121
UNITED BEHAVIORAL HEALTH
VA
01
87854M
SENTARA
VA
01
954796
COMPSYCH
VA
Enumeration date
06/21/2006
Last updated
07/09/2007
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