| Doctor Name: | MS. THYRA JACKSON BENOIT |
| NPI Number: | 1003936931 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C, LICSW |
| License Number: | LC300115 |
| Business Practice Address: | 1107 Spring St Ste A3 Silver Spring, MD - 209104027 |
| Business Phone Number: | 3014603735 |
| Business Fax Number: | 3014603735 |
| Mailing Address: | 1961 Middlebridge Dr, SILVER SPRING |
| State: | MD |
| Postal Code: | 209065822 |
| Phone Number: | 3014603735 |
| Fax Number: | 3014603735 |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC300115 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |