Provider Demographics
NPI:1306368022
Name:BENEDETTI, OPHELIA
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:
Last Name:BENEDETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-2924
Mailing Address - Country:US
Mailing Address - Phone:978-478-8392
Mailing Address - Fax:
Practice Address - Street 1:298 BROADWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-2924
Practice Address - Country:US
Practice Address - Phone:978-478-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANHP2024327OtherNEIGHBORHOOD HEALTH PLAN