Waltraut M Benjamin, MSW LICSW
Individual provider Active NPI Clinical Social Worker · Providence, RI
NPI 1104998772 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1104998772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- ISWOO164 (RI)
- Practice address
- 105 Medway St
Providence, RI 02906-4401 - Phone
- (401) 578-3666
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|
| ISWOO164 | RI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISWOO164 | RI | Yes |
Addresses
Primary practice location
105 Medway St
Providence, RI 02906-4401
Mailing address
59 New St
Rehoboth, MA 02769-2911
Phone (508) 252-4861
Other providers in Providence, RI
- Claudia Benitez
- Nicolas Benitez
- Kristen Michelle Benito
- Benjamin Vogel, MD, LLC
- Shijo Benjamin
- Joshua Bennett
- Kimberly Bennett
- Alina Benoit
- Eric Benoit
- Yahenys Benoit
All providers in Providence, RI · Clinical Social Worker in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.