Provider Demographics
NPI:1386742062
Name:BENHABIB, LYNNE SUZANNE
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:SUZANNE
Last Name:BENHABIB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:SUZANNE
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:12520 MAGNOLIA BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2355
Mailing Address - Country:US
Mailing Address - Phone:818-760-7676
Mailing Address - Fax:818-760-7685
Practice Address - Street 1:12520 MAGNOLIA BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-2355
Practice Address - Country:US
Practice Address - Phone:818-760-7676
Practice Address - Fax:818-760-7685
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13829103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist