Mike Benoit

Individual provider Active NPI Community/Behavioral Health Agency · Nottingham, MD

NPI 1417640418 · NPPES record last updated May 31, 2023

Key facts

NPI
1417640418
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
4041 Cedarside Dr
Nottingham, MD 21236-1655
Phone
(443) 823-8243
NPI assigned
May 26, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mens Sana LLC Community/Behavioral Health Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

4041 Cedarside Dr
Nottingham, MD 21236-1655

Mailing address

4041 Cedarside Dr
Nottingham, MD 21236-1655
Phone (443) 823-8243

Other providers in Nottingham, MD

All providers in Nottingham, MD · Community/Behavioral Health Agency in Maryland

Sources for this page

Verify at the official NPI Registry.