Healthcare Provider Details

I. General information

NPI: 1528983558
Provider Name (Legal Business Name): MR. JOSEPH ROBERT BENOIT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 CHOCTAW ST
ANDERSON SC
29626-4028
US

IV. Provider business mailing address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

V. Phone/Fax

Practice location:
  • Phone: 864-337-2134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19270
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: