Provider Demographics
NPI:1679173462
Name:BENCOSME CONSULTING, LLC
Entity Type:Organization
Organization Name:BENCOSME CONSULTING, LLC
Other - Org Name:BENCOSME CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENCOSME
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC,NCC,BCBA,RPT
Authorized Official - Phone:561-420-3810
Mailing Address - Street 1:123 WAKULLA SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4219
Mailing Address - Country:US
Mailing Address - Phone:561-420-3810
Mailing Address - Fax:
Practice Address - Street 1:12300 S SHORE BLVD STE 218
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6509
Practice Address - Country:US
Practice Address - Phone:561-420-3810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty