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Individual

JACOB EDWARD BENITES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2177 E WARNER RD STE 101, TEMPE, AZ 85284-3511
(480) 573-0000
Mailing address
2003 N MCALLISTER AVE, TEMPE, AZ 85288-1317
(520) 400-0476

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-23633
AZ
247200000X
Other Technician
Primary

Other

Enumeration date
07/01/2022
Last updated
03/05/2026
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