Individual
DR. JEFFREY MICHAEL BENWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16565
IL
101YP2500X
Professional Counselor
180-003264
IL
103T00000X
Psychologist
6108
OH
103TC0700X
Clinical Psychologist
Primary
071.007752
IL
Other
Enumeration date
09/01/2006
Last updated
03/05/2024
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