Provider Demographics
NPI:1356362107
Name:MASTAW-BENOIT, CHRISTIE LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LYNN
Last Name:MASTAW-BENOIT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BISHOP RD
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9454
Mailing Address - Country:US
Mailing Address - Phone:734-507-5000
Mailing Address - Fax:
Practice Address - Street 1:1220 BISHOP RD
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-9454
Practice Address - Country:US
Practice Address - Phone:734-507-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085740104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker