Individual
KIMBERLY LYNN BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCC, CADC-II, LCDC
Contact information
Practice address
8222 DOUGLAS AVE, DALLAS, TX 75225-5923
(901) 487-6577
Mailing address
8222 DOUGLAS AVE, DALLAS, TX 75225-5923
(901) 487-6577
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15120
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15120
TEXAS HEALTH AND HUMAN SERVICES COMMISSION
TX
Enumeration date
02/25/2021
Last updated
02/25/2021
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