Provider Demographics
NPI:1215146352
Name:BENTON, MARGARET E (PMHNP)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:E
Last Name:BENTON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 RIBAUT RD
Mailing Address - Street 2:BMAC CREDENTIALING
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5441
Mailing Address - Country:US
Mailing Address - Phone:843-522-5674
Mailing Address - Fax:
Practice Address - Street 1:BEAUFORT MEMORIAL SEA ISLAND PSYCHIATRY
Practice Address - Street 2:989 RIBAUT RD, STE 330
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5426
Practice Address - Country:US
Practice Address - Phone:843-522-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN223241363LP0808X
WAAP60909330363LP0808X
SC20831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4771Medicaid
VA013734P78Medicare PIN