Provider Demographics
NPI:1467791756
Name:DELEON-HERNANDEZ, BENITA (LCSW)
Entity Type:Individual
Prefix:
First Name:BENITA
Middle Name:
Last Name:DELEON-HERNANDEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1065
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-1065
Mailing Address - Country:US
Mailing Address - Phone:512-878-7401
Mailing Address - Fax:
Practice Address - Street 1:115 KOHLERS XING STE 330
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2467
Practice Address - Country:US
Practice Address - Phone:512-878-7401
Practice Address - Fax:512-353-0850
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53430101YM0800X
TX534501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health