Benjamin Clover, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

14202 Issued in CA

Practice address

4250 Fowler LN Ste 204
Diamond Springs, CA 95619-9782

Phone

(530) 626-3105

NPI assigned

Jul 31, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Benjamin Saubolle-Camacho Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Sierra Child and Family Services

  • Community/Behavioral Health Agency
  • Diamond Springs, CA
  • NPI 1144343609
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1073294104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3647 JENNY LIND AVE",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956605609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 FOWLER LN STE 204",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199782",
            "telephone_number": "530-626-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOVER",
        "first_name": "BENJAMIN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "14202",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "14202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENJAMIN",
            "last_name": "SAUBOLLE-CAMACHO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Carlson
• Jessica Lourdes Casillas
• Crystal Martha Castech-Tobias
• Joshua Emmanuel Castro
• Kyle Chamberlain
• Cynthia Coate, CINDY
• Jason Edward Collette
• Carol Collins
• Irvin Hafer Collins, MFT-A
• Justine Collinsworth, LMFT

• Professional Counselor in Diamond Springs, CA
• Providers in Diamond Springs, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.