Individual provider Active NPI

Benajah Marion, LCSW, LMFT

  • Clinical Social Worker
  • Moultrie, GA
National Provider Identifier
1295187581
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW000901 Issued in GA
Practice address
16 Tallokas Rd
Moultrie, GA 31768-5961
Phone
(229) 891-2819
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW000901 GA Primary
Marriage & Family Therapist 106H00000X MFT 000497 GA

Addresses

Primary practice location

16 Tallokas Rd
Moultrie, GA 31768-5961

Mailing address

16 Tallokas Rd
Moultrie, GA 31768-5961
Phone (229) 891-2819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180214002167 GA Practitioner - Clinical Social Worker 8022159599 Reassigns benefits to 1 organization
Practice locations: Moultrie, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

719 1St St SE
Moultrie, GA 31768-5509
Phone (229) 225-8296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW000901GAMDClinical Social Worker
MFT 000497GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Counseling Services Inc Clinical CurrentSince Feb 5, 2022 Accepting new patients

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1295187581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TALLOKAS RD",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317685961",
            "telephone_number": "229-891-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 TALLOKAS RD",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317685961",
            "telephone_number": "229-891-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARION",
        "first_name": "BENAJAH",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW000901",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT 000497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.