Individual provider Active NPI

Benjamin Neal Millsap, MSW, LCSW, LCAS, CCS

  • Clinical Social Worker
  • Albemarle, NC
National Provider Identifier
1629110168
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005395 Issued in NC
Practice address
350 Peedee Ave
Albemarle, NC 28001-4932
Phone
(704) 986-1554
NPI assigned
Feb 13, 2007
Last updated
Dec 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1046 NC
Clinical Social Worker 1041C0700X C005395 NC Primary

Addresses

Primary practice location

350 Peedee Ave
Albemarle, NC 28001-4932

Mailing address

350 Pee Dee Ave
Albemarle, NC 28001-4932
Phone (704) 986-1500

Other identifiers 1

IdentifierTypeStateIssuer
6111929MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1046NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1629110168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PEE DEE AVE",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014932",
            "telephone_number": "704-986-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PEEDEE AVE",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014932",
            "telephone_number": "704-986-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLSAP",
        "first_name": "BENJAMIN",
        "middle_name": "NEAL",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW, LCAS, CCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1046",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111929",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.