Provider Demographics
NPI:1568889301
Name:CARYN BENEVENTO-MUNROE
Entity Type:Organization
Organization Name:CARYN BENEVENTO-MUNROE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCMHC
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BENEVENTO-MUNROE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:802-233-6120
Mailing Address - Street 1:14 PRATT RD
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-3051
Mailing Address - Country:US
Mailing Address - Phone:802-233-6120
Mailing Address - Fax:
Practice Address - Street 1:14 PRATT RD
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-3051
Practice Address - Country:US
Practice Address - Phone:802-233-6120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680068550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty