Provider Demographics
NPI:1649483413
Name:BENITEZ, MARGARITA JANET (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:JANET
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12135 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1106
Mailing Address - Country:US
Mailing Address - Phone:718-445-2434
Mailing Address - Fax:
Practice Address - Street 1:12135 7TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1106
Practice Address - Country:US
Practice Address - Phone:917-887-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0510421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNZ721406371Medicare PIN