Benjamin Edwin Alexander-Eitzman, LCSW, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002954 Issued in NC

Practice address

114 Crestview LN
Boone, NC 28607-6415

Phone

(828) 355-9643

NPI assigned

Nov 7, 2012

Last updated

Nov 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Benjamin Edwin Eitzman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alamance Caswell Area MH DD Sa Area Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Burlington, NC
  • NPI 1023131711

  Clinical

  NPD (past)

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1407100803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CRESTVIEW LN",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286076415",
            "telephone_number": "828-355-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CRESTVIEW LN",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286076415",
            "telephone_number": "828-355-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER-EITZMAN",
        "first_name": "BENJAMIN",
        "middle_name": "EDWIN",
        "name_prefix": "Prof.",
        "credential": "LCSW, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENJAMIN",
            "last_name": "EITZMAN",
            "middle_name": "EDWIN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Boone, NC
• Providers in Boone, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.