| Benson Behavioral Health Pllc | |
|
1380 Hines St Se Salem OR 97302-2528 | |
| (512) 877-5752 | |
| Not Available |
| Full Name | Benson Behavioral Health Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1380 Hines St Se, Salem, Oregon |
| Authorized Official Name and Position | John Robert Benson (SOLE PROPRIETOR) |
| Authorized Official Contact | 5128775752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benson Behavioral Health Pllc 1380 Hines St Se Salem OR 97302-2528 Ph: (128) 775-7525 | Benson Behavioral Health Pllc 1380 Hines St Se Salem OR 97302-2528 Ph: (512) 877-5752 |
| NPI Number | 1467048975 |
|---|---|
| Provider Enumeration Date | 12/18/2020 |
| Last Update Date | 09/06/2023 |
| Certification Date | 07/25/2023 |
| Medicare PECOS PAC ID | 4587010350 |
|---|---|
| Medicare Enrollment ID | O20231031000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467048975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | John Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013478320 PECOS PAC ID: 3274866926 Enrollment ID: I20231031000640 |
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