Eric Bennett
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Malta, OH
NPI 1053809301 · NPPES record last updated Apr 23, 2018
Key facts
- NPI
- 1053809301
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CDCA.166859 (OH)
- Practice address
- 800 N Main St
Malta, OH 43758-9019 - Phone
- (304) 916-8468
- NPI assigned
- Apr 23, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| CDCA.166859 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Land of Goshen Treatment Center, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.166859 | OH | Yes |
Addresses
Primary practice location
800 N Main St
Malta, OH 43758-9019
Mailing address
81 Township Road 349
Ironton, OH 45638-8617
Phone (740) 442-7706
Other providers in Malta, OH
- Able Living Solutions LLC
- David Adkins
- Brandy Bailey
- Gary Beagle
- Douglas William Bobst Jr.
- Cody Bowen
- Susan M Boyer
- Kimberly Brannon
- Susan Eileen Bunner
All providers in Malta, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2018. 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.