Provider Demographics
NPI:1447462866
Name:BENJAMIN, DEIRDRE ANNE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:ANNE
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:DEIRDRE
Other - Middle Name:ANNE
Other - Last Name:ELKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:765 STARGATE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3843
Mailing Address - Country:US
Mailing Address - Phone:719-474-9077
Mailing Address - Fax:719-445-2216
Practice Address - Street 1:3055 AUSTIN BLUFFS PKWY STE C
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5758
Practice Address - Country:US
Practice Address - Phone:719-327-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker