Benjamin Fennimore, LCSW is a
Social Worker - Clinical based in Salem, Oregon. Benjamin Fennimore is licensed to practice in Oregon (license number L11039) and his current practice location is
1787 State St, Salem, Oregon. He can be reached at his office (for appointments etc.) via phone at
(503) 566-2132.
NPI number for Benjamin Fennimore is 1881094324 and his current mailing address is 2860 Winter St Se, Salem, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1881094324.
Healthcare Provider's Profile
| Full Name | Benjamin Fennimore |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 1787 State St, Salem, Oregon |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1881094324
- Provider Enumeration Date: 09/03/2014
- Last Update Date: 07/05/2023
Medical Identifiers
Medical identifiers for Benjamin Fennimore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881094324 | NPI | - | NPPES |
| 1417567983 | Medicaid | OR | |
| 1255964730 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | L11039 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Benjamin Fennimore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Benjamin Fennimore, LCSW
2860 Winter St Se,
Salem, OR 97302-3155
Ph: (503) 428-2948 | Benjamin Fennimore, LCSW
1787 State St,
Salem, OR 97301-4342
Ph: (503) 566-2132 |
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