Mary C Benjamin, LCSW

Individual provider Active NPI Clinical Social Worker · Geneva, IL

NPI 1619251295 · NPPES record last updated Sep 30, 2011

Key facts

NPI
1619251295
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149005658 (IL)
Practice address
39W408 W Burnham LN
Geneva, IL 60134-4892
Phone
(630) 232-2426
NPI assigned
Sep 30, 2011
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
149005658ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149005658 IL Yes

Addresses

Primary practice location

39W408 W Burnham LN
Geneva, IL 60134-4892

Mailing address

39W408 W Burnham LN
Geneva, IL 60134-4892
Phone (630) 232-2426

Other names

  • Mary C Cortes Benjamin Professional name

Other providers in Geneva, IL

All providers in Geneva, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.