Provider Demographics
NPI:1801981295
Name:BENOIT, SARAH JANE (LICSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:BENOIT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:STUART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:125 CHURCH ST
Mailing Address - Street 2:SUITE 90-104
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1929
Mailing Address - Country:US
Mailing Address - Phone:781-754-6545
Mailing Address - Fax:781-536-0016
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:SUITE 90-104
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1929
Practice Address - Country:US
Practice Address - Phone:781-754-6545
Practice Address - Fax:781-536-0016
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1132111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP08597OtherBLUE CROSS BLUE SHIELD
MAP08597OtherBLUE CROSS BLUE SHIELD