Individual provider Active NPI

Kathleen Benitez, LCSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1104044072
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072175 Issued in NY
Practice address
444 Saint Marks PL
Staten Island, NY 10301-2434
Phone
(718) 720-6727
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072175 NY Primary

Addresses

Primary practice location

444 Saint Marks PL
Staten Island, NY 10301-2434

Mailing address

444 Saint Marks PL
Staten Island, NY 10301-2434
Phone (718) 720-6727

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
072175NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1104044072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 SAINT MARKS PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012434",
            "telephone_number": "718-720-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 SAINT MARKS PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012434",
            "telephone_number": "718-720-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.