Provider Demographics
NPI:1598085482
Name:UGWU, BENET OBINNA (DMIN, LMHC, CASAC)
Entity Type:Individual
Prefix:DR
First Name:BENET
Middle Name:OBINNA
Last Name:UGWU
Suffix:
Gender:M
Credentials:DMIN, LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 242ND ST
Mailing Address - Street 2:3RR
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1949
Mailing Address - Country:US
Mailing Address - Phone:347-248-5643
Mailing Address - Fax:
Practice Address - Street 1:6711 242ND ST
Practice Address - Street 2:3RR
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1949
Practice Address - Country:US
Practice Address - Phone:347-248-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health