Provider Demographics
NPI:1700185352
Name:BENYI, STEPHANIE LAUREN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:BENYI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-3136
Mailing Address - Country:US
Mailing Address - Phone:650-365-7500
Mailing Address - Fax:
Practice Address - Street 1:3518 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-3136
Practice Address - Country:US
Practice Address - Phone:650-365-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP7591235Z00000X
CASP26728235Z00000X, 235Z00000X
NY021556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLP7591OtherAZ STATE LICENSURE SPEECH LANGUAGE PATHOLOGIST
AZ684519Medicaid
189115515OtherNPI NUMBER FOR FOUNDATION FOR HEARING RESEARCH, INC.
CASP26728OtherCA STATE LICENSURE SPEECH LANGUAGE PATHOLOGIST