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NPI Code Detail

MEDICARE: MS. SONJA LYNETTE BENFORD I LISW, MSWAC

MEDICARE: MS. SONJA LYNETTE BENFORD I LISW, MSWAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI-8243OH

General Provider Information

NPI Number : 1023114964
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SONJA LYNETTE BENFORD I LISW, MSWAC
Provider Business Mailing Address
First Line : 30 E BROAD ST
Second Line : 11TH FLOOR
City : COLUMBUS
State : OH
Zip : 43215-3414
Country : US
Telephone Number : 604-466-6583
Fax Number : 614-644-5331
Provider Business Practice Location Address
First Line : 1708 SOUTHPOINT DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1911
Country : US
Telephone Number : 216-787-0500
Fax Number : 216-787-0840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 07/08/2007

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