Lisa Dawn Bencher
Individual provider Active NPI Counselor · Pekin, IL
NPI 1285962423 · NPPES record last updated Nov 30, 2009
Key facts
- NPI
- 1285962423
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 3248 Vandever Ave
Pekin, IL 61554-6257 - Phone
- (309) 347-5579
- Fax
- (309) 347-4264
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
3248 Vandever Ave
Pekin, IL 61554-6257
Mailing address
3248 Vandever Ave
Pekin, IL 61554-6257
Phone (309) 347-5579
Other providers in Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2009. 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.