Jeffrey Walter Benner, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I9160 Issued in OH

Practice address

1456 Park Ave W
Mansfield, OH 44906-2700

Phone

(419) 529-4602

NPI assigned

Aug 9, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295745404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 TOWNSHIP ROAD 346",
            "city": "NOVA",
            "state": "OH",
            "postal_code": "448599746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062700",
            "telephone_number": "419-529-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "JEFFREY",
        "middle_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I9160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Sue Bellamy, PT
• Stacey Bellamy
• Jill Bender, PA
• Patricia Ann Bender, LPN
• Melissa Linn Benjamin, LCDC III
• Garrett Luke Bennett
• Gidget S Bennett, CMS
• Marley Bennett
• Donovyn Lamont Benson
• Sarah Beran

• Clinical Social Worker in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.