Individual
ELAINE BENEVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
003973
CT
101YP2500X
Professional Counselor
003973
CT
1041C0700X
Clinical Social Worker
Primary
003973
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004040572
—
CT
01
—
ANC1295
OXFORD
CT
01
—
CTGA000481
ABH
CT
Enumeration date
12/28/2009
Last updated
12/28/2009
Update your record
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