MEDICARE: MR. GIOVANNI BENAVIDES MHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	008725	NY

General Provider Information

NPI Number	:	1366839839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GIOVANNI BENAVIDES MHC

Provider Business Mailing Address
First Line	:	366 39TH ST APT 12
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-2955
Country	:	US
Telephone Number	:	718-813-2158
Fax Number	:

Provider Business Practice Location Address
First Line	:	366 39TH ST APT 12
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-2955
Country	:	US
Telephone Number	:	718-813-2158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2015
Last Update Date	:	05/10/2026

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