Provider Demographics
NPI:1457592743
Name:BENOIT, EVELYN A (LMFT)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:A
Last Name:BENOIT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 FARMINGTON AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2162
Mailing Address - Country:US
Mailing Address - Phone:860-212-0289
Mailing Address - Fax:
Practice Address - Street 1:998 FARMINGTON AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2162
Practice Address - Country:US
Practice Address - Phone:860-212-0289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000576106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist