Healthcare Provider Details

I. General information

NPI: 1700797461
Provider Name (Legal Business Name): CHRISTINA BENEFIEL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

8402 BLACKJACK RD
MOUNT VERNON OH
43050-9193
US

IV. Provider business mailing address

8402 BLACKJACK RD
MOUNT VERNON OH
43050-9193
US

V. Phone/Fax

Practice location:
  • Phone: 740-397-0442
  • Fax:
Mailing address:
  • Phone: 740-397-0442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0029155
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: