Provider Demographics
NPI:1437755212
Name:DOWDELL, BENITA DENISE (LCSWA)
Entity Type:Individual
Prefix:
First Name:BENITA
Middle Name:DENISE
Last Name:DOWDELL
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 E CONE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4533
Mailing Address - Country:US
Mailing Address - Phone:336-550-4040
Mailing Address - Fax:
Practice Address - Street 1:1471 E CONE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4533
Practice Address - Country:US
Practice Address - Phone:336-550-4040
Practice Address - Fax:336-550-4044
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0137641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty