Provider Demographics
NPI:1528685237
Name:BENITEZ, LIZET (LCSW)
Entity type:Individual
Prefix:
First Name:LIZET
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 E FERNHURST DR STE 801
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1587
Mailing Address - Country:US
Mailing Address - Phone:832-583-0324
Mailing Address - Fax:
Practice Address - Street 1:633 E FERNHURST DR STE 801
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1587
Practice Address - Country:US
Practice Address - Phone:832-583-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical