Individual provider Active NPI

Alexandra Benyaminov, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1245633635
Registry record updated Jan 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17516 Issued in MD
Practice address
2700 Willow Glen Dr
Baltimore, MD 21209-3103
Phone
(718) 640-5668
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2016

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 17516 MD Primary

Addresses

Primary practice location

2700 Willow Glen Dr
Baltimore, MD 21209-3103

Mailing address

2700 Willow Glen Dr
Baltimore, MD 21209-3103

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160725000053 MD Practitioner - Clinical Social Worker 3678866928 Reassigns benefits to 1 organization
Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2700 Willow Glen Dr
Baltimore, MD 21209-3103
Phone (443) 863-9254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17516MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Care LLC Clinical CurrentSince Aug 21, 2024 Accepting new patients
Ben1818Llc Past Accepting new patients

Organizations & group practices 2

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": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452297600000",
    "number": "1245633635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WILLOW GLEN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WILLOW GLEN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093103",
            "telephone_number": "718-640-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENYAMINOV",
        "first_name": "ALEXANDRA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2016-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.