Provider Demographics
NPI:1699836882
Name:BENZ, JOAN LOUISE (PHD, MSW, CSW-PIP)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:LOUISE
Last Name:BENZ
Suffix:
Gender:F
Credentials:PHD, MSW, CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 S AVALON AVE UNIT 202
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2537
Mailing Address - Country:US
Mailing Address - Phone:314-307-1117
Mailing Address - Fax:
Practice Address - Street 1:3701 W 49TH ST STE 202A
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106
Practice Address - Country:US
Practice Address - Phone:314-307-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2018-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030322421041C0700X
SD48211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical