Provider Demographics
NPI:1942275185
Name:BENSON-BLANKENSHIP, CHERYL A
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:BENSON-BLANKENSHIP
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:BENSON-BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2800 MARKET AVE N STE 14
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-1779
Mailing Address - Country:US
Mailing Address - Phone:330-497-1798
Mailing Address - Fax:330-497-1322
Practice Address - Street 1:2800 MARKET AVE N STE 14
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-1779
Practice Address - Country:US
Practice Address - Phone:330-497-1798
Practice Address - Fax:330-497-1322
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5520103TC1900X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling