Provider Demographics
NPI:1417723511
Name:BENOIT, YANINN PAMELA (LMSW)
Entity Type:Individual
Prefix:
First Name:YANINN
Middle Name:PAMELA
Last Name:BENOIT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 W SOUTHERN AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-4244
Mailing Address - Country:US
Mailing Address - Phone:480-999-1190
Mailing Address - Fax:
Practice Address - Street 1:2737 W SOUTHERN AVE STE 8
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4244
Practice Address - Country:US
Practice Address - Phone:480-999-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20994104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker