Individual provider Active NPI

Breanna Lee Benner-McKendrick

  • Social Worker
  • Streetsboro, OH
National Provider Identifier
1003777269
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
C.2507185-TRNE Issued in OH
Practice address
9150 Market Square Dr Ste 201
Streetsboro, OH 44241-4573
Phone
(330) 422-9005
NPI assigned
Nov 18, 2025
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X C.2507185-TRNE OH Primary

Addresses

Primary practice location

9150 Market Square Dr Ste 201
Streetsboro, OH 44241-4573

Mailing address

11465 Bowen Rd
Mantua, OH 44255-9455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C.2507185-TRNEOHMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1003777269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11465 BOWEN RD",
            "city": "MANTUA",
            "state": "OH",
            "postal_code": "442559455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 MARKET SQUARE DR STE 201",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442414573",
            "telephone_number": "330-422-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER-MCKENDRICK",
        "first_name": "BREANNA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "C.2507185-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.