Jamie Michael Bennett, LCSWA
Individual provider Active NPI Clinical Social Worker · Fort Drum, NY
NPI 1508395294 · NPPES record last updated Jun 7, 2017
Key facts
- NPI
- 1508395294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P009784 (NC)
- Practice address
- Ebh 1BCT 5TH Armored Division Drive
Fort Drum, NY 13602 - Phone
- (315) 772-1451
- NPI assigned
- Jun 7, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P009784 | NC | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P009784 | NC | Yes |
Addresses
Primary practice location
Ebh 1BCT 5TH Armored Division Drive
Fort Drum, NY 13602
Mailing address
21858 Oak Pointe LN Apt C
Watertown, NY 13601-5955
Phone (830) 282-9035
Other providers in Fort Drum, NY
- Britton Sterling Beckstead
- Ralf Beilhardt
- Matthew Todd Bell
- Todd L. Benham
- Dianna L Bennett
- Kayla Christine Bentz
- Erhard Alfred Beuttenmuller
- Sumon Bhattacharyya
- Mary Bice
- Randall Alan Bischoff
All providers in Fort Drum, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.