Individual provider Active NPI

Benjamin David Nesbitt, LICSW

  • Social Worker
  • Alexandria, MN
National Provider Identifier
1235497959
Registry record updated Mar 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
17537 Issued in MN
Practice address
121 5TH Ave W
Alexandria, MN 56308-1303
Phone
(320) 759-3096
Fax
(320) 759-3097
NPI assigned
May 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 17537 MN Primary

Addresses

Primary practice location

121 5TH Ave W
Alexandria, MN 56308-1303

Mailing address

121 5TH Ave W
Alexandria, MN 56308-1303
Phone (320) 759-3096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20200420001160 MN Practitioner - Clinical Social Worker 1153644281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
West Central Counseling LLCGroup PAC ID 4082019385, 2 clinicians

Practice addresses (Care Compare)

810 Henry Ave
Alexandria, MN 56308-5200
Phone (320) 759-3096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17537MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Counseling LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

810 Henry Ave
Alexandria, MN 56308
Phone (320) 759-3096

121 5th Ave W
Alexandria, MN 56308
Phone (320) 759-3096

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": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1235497959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 5TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081303",
            "telephone_number": "320-759-3096",
            "fax_number": "320-759-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 5TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081303",
            "telephone_number": "320-759-3096",
            "fax_number": "320-759-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESBITT",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-01",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "17537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.