Provider Demographics
NPI:1497985972
Name:BENEDETTO, KARA (LCSW)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:BENEDETTO
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 1:300 HEBRON AVE
Mailing Address - Street 2:SUITE 217
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2176
Mailing Address - Country:US
Mailing Address - Phone:860-659-2697
Mailing Address - Fax:860-659-3468
Practice Address - Street 1:300 HEBRON AVE
Practice Address - Street 2:SUITE 217
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2176
Practice Address - Country:US
Practice Address - Phone:860-659-2697
Practice Address - Fax:860-659-3468
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0069921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical