Provider Demographics
NPI:1447073390
Name:JUSTICE, D BENEE (LPC, CST)
Entity type:Individual
Prefix:DR
First Name:D
Middle Name:BENEE
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:LPC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 HOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3427
Mailing Address - Country:US
Mailing Address - Phone:334-595-3525
Mailing Address - Fax:
Practice Address - Street 1:1114 HOLDEN RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3427
Practice Address - Country:US
Practice Address - Phone:334-595-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health