Individual provider Active NPI

Nicole D Benedict, M.S., L.M.F.T

  • Marriage & Family Therapist
  • Plantation, FL
National Provider Identifier
1952420523
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2046 Issued in FL
Practice address
7501 NW 12TH St
Plantation, FL 33313-5921
Phone
(954) 560-2082
Fax
(954) 958-1620
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT2046 FL Primary

Addresses

Primary practice location

7501 NW 12TH St
Plantation, FL 33313-5921

Mailing address

7501 NW 12TH St
Plantation, FL 33313-5921
Phone (954) 560-2082

Other identifiers 1

IdentifierTypeStateIssuer
765824900MedicaidFL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MT2046FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952420523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 NW 12TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333135921",
            "telephone_number": "954-560-2082",
            "fax_number": "954-958-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 NW 12TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333135921",
            "telephone_number": "954-560-2082",
            "fax_number": "954-958-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "M.S., L.M.F.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765824900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.