MEDICARE: KRISTEN L BENSLEY LCSW

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
1	1041C0700X	Clinical Social Worker	SW25550	FL

General Provider Information

NPI Number	:	1346125606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN L BENSLEY LCSW

Provider Business Mailing Address
First Line	:	1938 SW BEEKMAN ST
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-1727
Country	:	US
Telephone Number	:	772-626-0157
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 20TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-3571
Country	:	US
Telephone Number	:	772-271-2924
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	10/08/2025

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