Camille Benedict, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13220 Issued in MD

Practice address

1282 Smallwood Dr W
Suite 146
Waldorf, MD 20603-4732

Phone

(240) 424-9578

Fax

(240) 607-2452

NPI assigned

Nov 24, 2010

Sex

Female

Sole proprietor

Yes

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

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Legacy Medical Clinic With Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Temple Hills, MD
  • NPI 1487272910

  MD

  Medicare reassignment

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1174825152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 SMALLWOOD DR W",
            "address_2": "SUITE 146",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034732",
            "telephone_number": "240-424-9578",
            "fax_number": "240-607-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 SMALLWOOD DR W",
            "address_2": "SUITE 146",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034732",
            "telephone_number": "240-424-9578",
            "fax_number": "240-607-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "CAMILLE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-24",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shale Beharie
• Behavioral Health Affiliates LLC
• Kristen Marie Belger, DMD
• Ebony Belt
• Belvonae Health & Wellness LLC
• Melanie Benjamin, PHARMD.
• Wendell Bennett Hester
• Ebonique T Bennett, NP
• Fanta Beretey
• Rachel Elizabeth Bernhardt, OTR/L

• All providers in Waldorf, MD
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.