Healthcare Provider Details

I. General information

NPI: 1396664082
Provider Name (Legal Business Name): SAMANTHA BENWITZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ALLENS CREEK RD
ROCHESTER NY
14618-3250
US

IV. Provider business mailing address

15 COACHLIGHT CIR
FARMINGTON NY
14425-9317
US

V. Phone/Fax

Practice location:
  • Phone: 585-474-3010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103396
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: