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General NPI Number Information
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NPI Number | 1578174041
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Entity Type | Individual
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Provider Name | SYDNEY BENTON LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | PO BOX 58112
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City | RENTON
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State | WA
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Zip | 98058-1112
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Country | US
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Telephone | 425-728-0558
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 RAINIER AVE S STE 201
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City | SEATTLE
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State | WA
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Zip | 98144-4642
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61626649
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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