Provider Demographics
NPI:1922011139
Name:BENSKY, THERESA R (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:R
Last Name:BENSKY
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801
Mailing Address - Country:US
Mailing Address - Phone:641-782-6832
Mailing Address - Fax:641-782-6832
Practice Address - Street 1:900 W MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801
Practice Address - Country:US
Practice Address - Phone:641-782-6832
Practice Address - Fax:641-782-6832
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA012221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA01199OtherBLUE CROSS / BLUE SHEILD