Provider Demographics
NPI:1043374978
Name:BENEDUCI, DAVID JOSEPH SR (MS LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:BENEDUCI
Suffix:SR
Gender:M
Credentials:MS LPC
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:JOSEPH
Other - Last Name:BENEDUCI
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:107 ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07756-1401
Mailing Address - Country:US
Mailing Address - Phone:732-610-3112
Mailing Address - Fax:
Practice Address - Street 1:107 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:OCEAN GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07756-1401
Practice Address - Country:US
Practice Address - Phone:732-610-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ210634494OtherEMPLOYER TAX I.D. NUMBER