Healthcare Provider Details

I. General information

NPI: 1760292734
Provider Name (Legal Business Name): KIMBERLY M BENIGSOHN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 BECKNER RD
SANTA FE NM
87507-3691
US

IV. Provider business mailing address

6404 JAGUAR DR
SANTA FE NM
87507-1702
US

V. Phone/Fax

Practice location:
  • Phone: 303-241-1786
  • Fax:
Mailing address:
  • Phone: 303-241-1786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: