Darral N Bennett Jr., LICSW
Individual provider Active NPI Clinical Social Worker · Clarksburg, WV
NPI 1013677590 · NPPES record last updated Dec 23, 2021
Key facts
- NPI
- 1013677590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- DP00945125 (WV)
- Practice address
- 1 Medical Center Dr
Clarksburg, WV 26301 - Phone
- (304) 623-3461
- NPI assigned
- Dec 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DP00945125 | WV | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | DP00945125 | WV | Yes |
Addresses
Primary practice location
1 Medical Center Dr
Clarksburg, WV 26301
Mailing address
338 Ridgeway Dr
Bridgeport, WV 26330-1276
Phone (304) 841-8625
Other providers in Clarksburg, WV
- Terri Leanne Belcher
- Billiee Bell
- Samuel J Bellotte
- Benchmark Therapy, Inc
- Carol Louise Bennett
- Debra Dawn Bennett
- Hollie Bennett
- Kimberly Ann Bennett
- Lauren Bennett
- N'Shay Bennett
All providers in Clarksburg, WV · Clinical Social Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.