Healthcare Provider Details
I. General information
NPI: 1780025791
Provider Name (Legal Business Name): KELSEY BENSKIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/08/2013
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1628 OKLAHOMA AVE
TRENTON MO
64683-2565
US
IV. Provider business mailing address
1601 OLD SOUTH RIVER RD
SAINT CHARLES MO
63303-4120
US
V. Phone/Fax
- Phone: 660-359-4600
- Fax:
- Phone: 636-224-1210
- Fax: 636-246-1008
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 2023018624 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 2025018022 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: