Provider Demographics
NPI:1295746964
Name:BENZENHAFER, PATRICIA P (LCPC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:P
Last Name:BENZENHAFER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 GUYER ST.
Mailing Address - Street 2:UNIT B
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265
Mailing Address - Country:US
Mailing Address - Phone:618-420-4639
Mailing Address - Fax:
Practice Address - Street 1:5 OAK BRANCH DR
Practice Address - Street 2:SUITE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2169
Practice Address - Country:US
Practice Address - Phone:336-297-9009
Practice Address - Fax:336-297-0062
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.005972101YP2500X
NC7112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104021Medicaid