Healthcare Provider Details

I. General information

NPI: 1619895232
Provider Name (Legal Business Name): ALEXA DAYANA ROMAN BENITEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 W CONE BLVD STE 223
GREENSBORO NC
27408-4067
US

IV. Provider business mailing address

6805 POPLAR GROVE TRL
GREENSBORO NC
27410-8641
US

V. Phone/Fax

Practice location:
  • Phone: 336-542-2884
  • Fax: 336-542-2885
Mailing address:
  • Phone: 336-862-9687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023961
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: