Provider Demographics
NPI:1407072291
Name:BENSON, STACIE (LPC)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2727 W 92ND AVE
Practice Address - Street 2:SUITE 100C
Practice Address - City:FEDERAL HEIGHTS
Practice Address - State:CO
Practice Address - Zip Code:80260-5221
Practice Address - Country:US
Practice Address - Phone:303-941-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health