Provider Demographics
NPI:1740857986
Name:BENN, STANLEY JUNIOUS (LCPC)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:JUNIOUS
Last Name:BENN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 ERWIN DR
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3725
Mailing Address - Country:US
Mailing Address - Phone:410-622-4547
Mailing Address - Fax:
Practice Address - Street 1:1042 ERWIN DR
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3725
Practice Address - Country:US
Practice Address - Phone:410-622-4547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional