MEDICARE: SHERRICE BENJAMIN MA, LLPC, CCTP

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
2	171M00000X	Case Manager/Care Coordinator	6803086712	MI
3	101YP2500X	Professional Counselor	6401015065	MI

General Provider Information

NPI Number	:	1912386822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRICE BENJAMIN MA, LLPC, CCTP

Provider Business Mailing Address
First Line	:	13630 PEARSON ST
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-2760
Country	:	US
Telephone Number	:	313-687-7506
Fax Number	:

Provider Business Practice Location Address
First Line	:	7724 14TH ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48206-2644
Country	:	US
Telephone Number	:	734-847-3802
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	07/09/2025

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