Active NPI
Freddy V Benjamin, CSW
- Addiction (Substance Use Disorder) Counselor
- Matawan, NJ
National Provider Identifier
1255669602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 166 Main St
Matawan, NJ 07747-3104 - Phone
- (732) 290-9040
- NPI assigned
- Nov 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
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
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
166 Main St
Matawan, NJ 07747-3104
Mailing address
190 Jackson St
Matawan, NJ 07747-3102
Phone (732) 970-7687
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 23, 2009.
{
"created_epoch": "1258934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258934400000",
"number": "1255669602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 JACKSON ST",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "077473102",
"telephone_number": "732-970-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 MAIN ST",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "077473104",
"telephone_number": "732-290-9040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "FREDDY",
"middle_name": "V",
"name_prefix": "Mr.",
"credential": "CSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-23",
"last_updated": "2009-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Matawan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.