Provider Demographics
NPI:1043767692
Name:BENSON, BARBARA (EDS, LAC, NCC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:EDS, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 4B THIRD ST.
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505
Mailing Address - Country:US
Mailing Address - Phone:609-456-8497
Mailing Address - Fax:
Practice Address - Street 1:165 4B THIRD ST.
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505
Practice Address - Country:US
Practice Address - Phone:609-456-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00324600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional