Stacey, Charles Benson

Stacey, Charles Benson is an individual health care provider with primary practice located at 3510 Messina Dr , Farmington NM 87402-4782. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Stacey, Charles Benson can be contacted via phone (832) 630-3022.

Contact Information

Primary practice address
3510 Messina Dr Farmington NM 87402-4782
Phone: (832) 630-3022
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4426 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X CMF0068702 New Mexico

Profile Details

NPI number 1699985259
LBN Legal business name Stacey, Charles Benson
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Feb 29th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699985259 NPPES
New Mexico MEDICAID 84254289

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