Kristen Dukes Benfield, LPC

Individual provider Active NPI Professional Counselor · Pavo, GA

NPI 1295070738 · NPPES record last updated Jan 20, 2016

Key facts

NPI
1295070738
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC008406 (GA)
Practice address
1534 Simmons Rd
Pavo, GA 31778-4107
Phone
(229) 403-5062
NPI assigned
Dec 10, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC008406GAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X LPC008406 GA Yes

Addresses

Primary practice location

1534 Simmons Rd
Pavo, GA 31778-4107

Mailing address

1534 Simmons Rd
Pavo, GA 31778-4107
Phone (229) 403-5062

Other providers in Pavo, GA

All providers in Pavo, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.