Joseph Benner, LPC, LADC
Individual provider Active NPI Counselor · Newtown, CT
NPI 1104358738 · NPPES record last updated Jul 14, 2023
Key facts
- NPI
- 1104358738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 3519 (CT)
- Practice address
- 87 S Main St Ste 14
Newtown, CT 06470-2315 - Phone
- (203) 666-1605
- Fax
- (475) 323-2144
- NPI assigned
- Apr 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3519 | CT | MD | Clinical Psychologist |
| 1234 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JGB Professional Counseling, LLC | Counselor | Current |
Accepting new patients |
Locations
87 S Main St
Ste 14
Newtown, CT 06470
Phone (203) 666-1605
107 Church Hill Rd
Ste 1
Sandy Hook, CT 06482
Phone (203) 270-9888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1234 | CT | |
| Mental Health Counselor | 101YM0800X | 3519 | CT | |
| Counselor | 101Y00000X | 3519 | CT | Yes |
Addresses
Primary practice location
87 S Main St Ste 14
Newtown, CT 06470-2315
Mailing address
215 Jacqueline Dr
Southbury, CT 06488-2354
Phone (203) 666-1605
Other providers in Newtown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.