| Organization Name: | AMANDA BENSON COUNSELING, LLC |
| NPI Number: | 1083083448 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA BENSON (LCPC) |
| Mailing Address: | 1161 Fortune Blvd Ste 400 Shiloh |
| State: | IL US |
| Postal Code: | 622697385 |
| Phone Number: | 6188308146 |
| Fax Number: | 6182068476 |
| NPI Enumeration Date: | 09/16/2015 |
| NPI Last Update Date: | 09/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180.008106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |