Provider Demographics
NPI:1427320183
Name:BENAIM, JENNIFER (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BENAIM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6830
Mailing Address - Country:US
Mailing Address - Phone:561-744-8889
Mailing Address - Fax:561-354-0189
Practice Address - Street 1:1001 W INDIANTOWN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6830
Practice Address - Country:US
Practice Address - Phone:561-744-8889
Practice Address - Fax:561-354-0189
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10942101YP2500X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ03LXOtherBLUE CROSS BLUE SHIELD