Healthcare Provider Details

I. General information

NPI: 1558722710
Provider Name (Legal Business Name): WHITTNI BENJAMIN LPC, NCC, CADC, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N SHIAWASSEE ST STE A
CORUNNA MI
48817-1444
US

IV. Provider business mailing address

4214 CHARTER OAK DR
FLINT MI
48507-5512
US

V. Phone/Fax

Practice location:
  • Phone: 989-494-0404
  • Fax:
Mailing address:
  • Phone: 608-772-5275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401019490
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: