Debra Henriette Benveniste, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2203 Issued in CT

Practice address

1039 N Main St
Dayville, CT 06241-2170

Phone

(860) 774-2365

NPI assigned

Feb 11, 2006

Last updated

Nov 29, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Gilead Community Services, Inc.

  • Community/Behavioral Health Agency
  • Middletown, CT
  • NPI 1467705715
  NPD (past)
• Gilead Community Services, Inc.

  • Adult Mental Health Clinic/Center
  • Middletown, CT
  • NPI 1518948025
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1619940301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172",
            "address_2": "1039 NORTH MAIN STREET",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "06241",
            "telephone_number": "860-774-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENVENISTE",
        "first_name": "DEBRA",
        "middle_name": "HENRIETTE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-11",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "2203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "140002203CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RI",
            "identifier": "62 43455",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "167743",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "134225",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004201638",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P3592342",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Loren Baloga
• Sara Barber, LCSW
• Laura G Barker-Mercurio, LMSW
• Isabel Barrett, LMSW
• Madison Rae Belanger, LMSW
• Judith Marie Bergeron, LCSW
• Julie Bernier
• Breanna Bohle, LMSW
• Cathy Boisvert, LCSW
• Jayme Faye Boling, LMSW

• Clinical Social Worker in Dayville, CT
• Providers in Dayville, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.