Healthcare Provider Details

I. General information

NPI: 1871708453
Provider Name (Legal Business Name): MONICA JILL FREEMAN-BENNEFIELD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONICA JILL MASSEY CT

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10029 CLEVELAND AVE SE
MAGNOLIA OH
44643-9781
US

IV. Provider business mailing address

6127 LAVENHAM RD SW
MASSILLON OH
44646-9676
US

V. Phone/Fax

Practice location:
  • Phone: 234-386-0306
  • Fax: 234-386-0108
Mailing address:
  • Phone: 330-795-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2204702
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: