Provider Demographics
NPI:1073385399
Name:FORBES-BENJAMIN, JESENIA (LLPC)
Entity Type:Individual
Prefix:
First Name:JESENIA
Middle Name:
Last Name:FORBES-BENJAMIN
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 KING HWY
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2579
Mailing Address - Country:US
Mailing Address - Phone:269-598-2837
Mailing Address - Fax:
Practice Address - Street 1:834 KING HWY
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2579
Practice Address - Country:US
Practice Address - Phone:269-598-2837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional