Stacy Benson, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Danbury, CT

NPI 1770944480 · NPPES record last updated Mar 9, 2016

Key facts

NPI
1770944480
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
001190 (CT)
Practice address
60 Beaver Brook Rd
Danbury, CT 06810-6239
Phone
(203) 743-7574
NPI assigned
Mar 9, 2016
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
001190CTMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 001190 CT Yes

Addresses

Primary practice location

60 Beaver Brook Rd
Danbury, CT 06810-6239

Mailing address

60 Beaver Brook Rd
Danbury, CT 06810-6239
Phone (203) 743-7574

Other identifiers

IdentifierTypeStateIssuer
001190OtherCTCONNECTICUT DEPARTMENT OF PUBLIC HEALTH

Other providers in Danbury, CT

All providers in Danbury, CT · Addiction (Substance Use Disorder) Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.