Bethany G Benjamin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61031123 Issued in WA

Practice address

2201 NE 112TH Ave Apt G57
Vancouver, WA 98684-4266

Phone

(509) 520-7164

NPI assigned

Nov 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bethanybenjamin@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD
• Real Life Counseling PLLC

  • Clinical Social Worker
  • Vancouver, WA
  • NPI 1053782078
  NPD (past)

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1124561295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 NE 112TH AVE APT G57",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844266",
            "telephone_number": "509-520-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 NE 112TH AVE APT G57",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844266",
            "telephone_number": "509-520-7164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1498 SE Tech Center Pl Ste 300",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986835509",
            "country_code": "US",
            "telephone_number": "360-619-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "BETHANY",
        "middle_name": "G",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61031123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiri Benedict
• Tamara Benedict
• Cecilia Lizbeth Benitez Soto
• Alberto Benitez
• Hannah Elizabeth Benitez
• Bailey Benn, MA, LPCI
• Kevan Benn, MD
• Alexis Bennett, MSW
• Andrew James Bennett, PHARMD
• Chelsea Gwynn Bennett, WHNP

• Clinical Social Worker in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.