Provider Demographics
NPI:1033616248
Name:BENNEFIELD & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BENNEFIELD & ASSOCIATES, LLC
Other - Org Name:MICHELE BENNEFIELD
Other - Org Type:Other Name
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-313-9032
Mailing Address - Street 1:400 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2251
Mailing Address - Country:US
Mailing Address - Phone:864-313-9032
Mailing Address - Fax:866-808-0926
Practice Address - Street 1:400 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2251
Practice Address - Country:US
Practice Address - Phone:864-313-9032
Practice Address - Fax:866-808-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1359Medicaid