Provider Demographics
NPI:1770757239
Name:BENSON, LINDSAY ELISE (AUD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ELISE
Last Name:BENSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:895 MIDDLE GROUND BLVD
Practice Address - Street 2:SUITE 152
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4250
Practice Address - Country:US
Practice Address - Phone:757-599-5505
Practice Address - Fax:757-599-3618
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001284231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1770757239Medicaid
VA1770757239Medicaid
VAP00975422Medicare PIN