Healthcare Provider Details

I. General information

NPI: 1487986246
Provider Name (Legal Business Name): FAITH BENFORD-BONO LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 KEARNEY AVE
SEASIDE HEIGHTS NJ
08751-1876
US

IV. Provider business mailing address

258 KEARNEY AVE
SEASIDE HEIGHTS NJ
08751-1876
US

V. Phone/Fax

Practice location:
  • Phone: 862-346-7275
  • Fax:
Mailing address:
  • Phone: 862-346-7275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00383900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: