Individual provider Active NPI

Benjamin Wood

  • Clinical Social Worker
  • East Palo Alto, CA
National Provider Identifier
1124513296
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59696 Issued in TX
Practice address
2560 Pulgas Ave
East Palo Alto, CA 94303-1323
Phone
(866) 325-6466
NPI assigned
Jun 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 59696 TX Primary

Addresses

Primary practice location

2560 Pulgas Ave
East Palo Alto, CA 94303-1323

Mailing address

2560 Pulgas Ave
East Palo Alto, CA 94303-1323
Phone (866) 325-6466

Other practice location 1

26 Central Ave
Redwood City, CA 94061-3823
Phone (650) 367-9030

Other identifiers 2

IdentifierTypeStateIssuer
ASW83240OtherCACALIFORNIA BOARD OF BEHAVIORAL SCIENCES
LCSW59696OtherTXTEXAS BOARD OF SOCIAL WORK EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
59696TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Our Common Ground, Inc. PastSince Dec 31, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124513296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 PULGAS AVE",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031323",
            "telephone_number": "866-325-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 PULGAS AVE",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031323",
            "telephone_number": "866-325-6466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940613823",
            "country_code": "US",
            "telephone_number": "650-367-9030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "ASW83240",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "LCSW59696",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.