Individual
MS. DEBRA HENRIETTE BENVENISTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1039 N MAIN ST, DAYVILLE, CT 06241-2170
(860) 774-2365
Mailing address
PO BOX 172, 1039 NORTH MAIN STREET, DAYVILLE, CT 06241
(860) 774-2365
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2203
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004201638
—
CT
01
—
134225
VALUE OPTIONS
CT
01
—
140002203CT03
ANTHEM BCBS
CT
01
—
167743
MHN
CT
01
—
62 43455
BCBS RI
CT
01
—
P3592342
OXFORD HEALTH PLANS
CT
Enumeration date
02/11/2006
Last updated
11/29/2012
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