Provider Demographics
NPI:1790943116
Name:BENSON, WILLIAM (LMFT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BENSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 N CRESCENT HEIGHTS BLVD
Mailing Address - Street 2:#10
Mailing Address - City:W HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5048
Mailing Address - Country:US
Mailing Address - Phone:310-849-9399
Mailing Address - Fax:323-656-4440
Practice Address - Street 1:7985 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:W HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5074
Practice Address - Country:US
Practice Address - Phone:310-849-9399
Practice Address - Fax:323-656-4440
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37686106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist