Provider Demographics
NPI:1396815072
Name:DOBBIN, BENSON H (LCSW)
Entity type:Individual
Prefix:
First Name:BENSON
Middle Name:H
Last Name:DOBBIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 700 E
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2801
Mailing Address - Country:US
Mailing Address - Phone:801-567-7565
Mailing Address - Fax:801-355-9322
Practice Address - Street 1:515 S 700 E
Practice Address - Street 2:SUITE 3A
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2801
Practice Address - Country:US
Practice Address - Phone:801-567-7565
Practice Address - Fax:801-355-9322
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT134744-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical