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NPI Code Detail

MEDICARE: MS. SHARON K WILLISTON-BENADUM LPC

MEDICARE: MS. SHARON K WILLISTON-BENADUM LPC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor162155OH
2101YP2500XProfessional CounselorC.0900057OH
3101YM0800XMental Health CounselorE0900057OH

General Provider Information

NPI Number : 1407188550
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARON K WILLISTON-BENADUM LPC
Provider Business Mailing Address
First Line : 100 DORCHESTER SQ N STE 102
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-7305
Country : US
Telephone Number : 161-489-0826
Fax Number : 614-776-5333
Provider Business Practice Location Address
First Line : 100 DORCHESTER SQ N STE 102
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-7305
Country : US
Telephone Number : 614-890-8262
Fax Number : 614-776-5333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2010
Last Update Date : 08/31/2021

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