Provider Demographics
NPI:1477343606
Name:BENSON, CARISA THELMA (CD, PCD, CBC)
Entity type:Individual
Prefix:MRS
First Name:CARISA
Middle Name:THELMA
Last Name:BENSON
Suffix:
Gender:
Credentials:CD, PCD, CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WESTSIDE BLVD APT 250
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-2317
Mailing Address - Country:US
Mailing Address - Phone:985-208-5204
Mailing Address - Fax:
Practice Address - Street 1:400 WESTSIDE BLVD APT 250
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-2317
Practice Address - Country:US
Practice Address - Phone:985-208-5204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty