Provider Demographics
NPI:1073624359
Name:BENTON, MARGARET NEL (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:NEL
Last Name:BENTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NEL
Other - Middle Name:
Other - Last Name:BENTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:834 E PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3534
Mailing Address - Country:US
Mailing Address - Phone:719-577-9426
Mailing Address - Fax:
Practice Address - Street 1:115 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3130
Practice Address - Country:US
Practice Address - Phone:719-572-6340
Practice Address - Fax:719-447-4791
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9917171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical