Provider Demographics
NPI:1851449201
Name:BENHAM, CHARITY JOY
Entity type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:JOY
Last Name:BENHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 SW MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1124
Mailing Address - Country:US
Mailing Address - Phone:503-550-7139
Mailing Address - Fax:503-537-7007
Practice Address - Street 1:2153 SW MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1124
Practice Address - Country:US
Practice Address - Phone:503-550-7139
Practice Address - Fax:503-537-7007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1816103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical