Provider Demographics
NPI:1619753548
Name:BENTHOS GROUP LLC
Entity Type:Organization
Organization Name:BENTHOS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-663-5701
Mailing Address - Street 1:3 MARK TWAIN LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-2227
Mailing Address - Country:US
Mailing Address - Phone:310-663-5701
Mailing Address - Fax:
Practice Address - Street 1:3 MARK TWAIN LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-2227
Practice Address - Country:US
Practice Address - Phone:310-663-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty