Provider Demographics
NPI:1649052770
Name:BENJAMIN, DIONNE B (LCPC)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:B
Last Name:BENJAMIN
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 1:8385 FLINTLOCK CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2555
Mailing Address - Country:US
Mailing Address - Phone:240-761-4972
Mailing Address - Fax:
Practice Address - Street 1:8181 PROFESSIONAL PL STE 200
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-7219
Practice Address - Country:US
Practice Address - Phone:301-306-4590
Practice Address - Fax:301-880-0054
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MDLC15229101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health