Provider Demographics
NPI:1467141754
Name:BENSON, SABRINA LYNEICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:LYNEICE
Last Name:BENSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 BAYBURY LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-5805
Mailing Address - Country:US
Mailing Address - Phone:601-672-7529
Mailing Address - Fax:
Practice Address - Street 1:262 BAYBURY LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-5805
Practice Address - Country:US
Practice Address - Phone:601-672-7529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1066251041C0700X
MSC105391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical