Provider Demographics
NPI:1194165530
Name:BENYSHEK, DENITA M (PHD)
Entity type:Individual
Prefix:DR
First Name:DENITA
Middle Name:M
Last Name:BENYSHEK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 SE 27TH ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3060
Mailing Address - Country:US
Mailing Address - Phone:206-588-5278
Mailing Address - Fax:206-902-5288
Practice Address - Street 1:7650 SE 27TH ST
Practice Address - Street 2:SUITE 503
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-3060
Practice Address - Country:US
Practice Address - Phone:206-588-5278
Practice Address - Fax:206-902-5288
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-30
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60349683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health