Individual provider Active NPI

Shawndra Benjamin, CIT

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, LA
National Provider Identifier
1740052240
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
5710 Issued in LA
Practice address
645 Highway 80 E
Monroe, LA 71203-8527
Phone
(318) 343-6966
NPI assigned
Oct 27, 2023
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 5710 LA Primary
Counselor 101Y00000X NU
Case Manager/Care Coordinator 171M00000X 5710 LA

Addresses

Primary practice location

645 Highway 80 E
Monroe, LA 71203-8527

Mailing address

427 Birchwood Dr
Monroe, LA 71203-2205
Phone (318) 351-6795

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5710LAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1740052240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 BIRCHWOOD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032205",
            "telephone_number": "318-351-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 HIGHWAY 80 E",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712038527",
            "telephone_number": "318-343-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "SHAWNDRA",
        "credential": "CIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "LA",
            "license": "5710",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "5710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.