Provider Demographics
NPI:1871708453
Name:FREEMAN-BENNEFIELD, MONICA JILL (LPC)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:JILL
Last Name:FREEMAN-BENNEFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:JILL
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CT
Mailing Address - Street 1:6127 LAVENHAM RD SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9676
Mailing Address - Country:US
Mailing Address - Phone:330-795-5437
Mailing Address - Fax:
Practice Address - Street 1:10921 REED HARTMAN HWY STE 133
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2851
Practice Address - Country:US
Practice Address - Phone:513-984-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204702101Y00000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical