Healthcare Provider Details

I. General information

NPI: 1053275735
Provider Name (Legal Business Name): REGINA BENKO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 BIRCHARD PARK
MIDDLEBURY VT
05753-8817
US

IV. Provider business mailing address

PO BOX 153
VERGENNES VT
05491-0153
US

V. Phone/Fax

Practice location:
  • Phone: 802-349-0224
  • Fax:
Mailing address:
  • Phone: 802-877-2429
  • Fax: 802-877-2292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0970136131
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: