Provider Demographics
NPI:1093035958
Name:WILLIAMS, BENJAMIN (LPC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 LEISURE LN
Mailing Address - Street 2:
Mailing Address - City:SILETZ
Mailing Address - State:OR
Mailing Address - Zip Code:97380-9620
Mailing Address - Country:US
Mailing Address - Phone:541-992-3309
Mailing Address - Fax:
Practice Address - Street 1:1684 N COAST HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-2357
Practice Address - Country:US
Practice Address - Phone:541-270-6849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1013952829Medicaid