Provider Demographics
NPI:1639203342
Name:MONFREDO, BENJAMIN FRANCIS (MA, CAGS)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:FRANCIS
Last Name:MONFREDO
Suffix:
Gender:M
Credentials:MA, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1703
Mailing Address - Country:US
Mailing Address - Phone:508-829-5480
Mailing Address - Fax:
Practice Address - Street 1:340 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1604
Practice Address - Country:US
Practice Address - Phone:508-926-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health