Provider Demographics
NPI:1912593294
Name:BENZING, LORRAINE H (LCSW)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:H
Last Name:BENZING
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 1:5256 GREIG RD
Mailing Address - Street 2:
Mailing Address - City:GREIG
Mailing Address - State:NY
Mailing Address - Zip Code:13345-1804
Mailing Address - Country:US
Mailing Address - Phone:315-486-6903
Mailing Address - Fax:
Practice Address - Street 1:20104 NYS ROUTE 3
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-5555
Practice Address - Country:US
Practice Address - Phone:315-779-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090476-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical