Provider Demographics
NPI:1740825934
Name:BENTON, AUBREY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:BENTON
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E WILSON ST STE 180
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-3168
Mailing Address - Country:US
Mailing Address - Phone:630-879-1091
Mailing Address - Fax:
Practice Address - Street 1:1001 E WILSON ST STE 180
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-3168
Practice Address - Country:US
Practice Address - Phone:630-879-1091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0250661041C0700X
IL150.103974104100000X
IA1244961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker