Provider Demographics
NPI:1003820945
Name:BENYAK, DONALIE M (LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:DONALIE
Middle Name:M
Last Name:BENYAK
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 DEL PRADO BLVD S STE 202
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3628
Mailing Address - Country:US
Mailing Address - Phone:239-772-5091
Mailing Address - Fax:239-772-8921
Practice Address - Street 1:923 DEL PRADO BLVD S STE 202
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3628
Practice Address - Country:US
Practice Address - Phone:239-772-5091
Practice Address - Fax:239-772-8921
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health