Provider Demographics
NPI:1801042825
Name:BENJAMIN, CELENA (LMHC, BCBA, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CELENA
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:LMHC, BCBA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 6TH LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-1583
Mailing Address - Country:US
Mailing Address - Phone:772-713-4031
Mailing Address - Fax:
Practice Address - Street 1:950 6TH LN
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962
Practice Address - Country:US
Practice Address - Phone:772-713-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-10
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5878101YM0800X
FL1010478103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health