Healthcare Provider Details

I. General information

NPI: 1316585490
Provider Name (Legal Business Name): BENJAMIN C DOWNARD LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 COUNTY ROAD 15 STE C
BRYAN OH
43506-9767
US

IV. Provider business mailing address

22251 STATE ROUTE 2
ARCHBOLD OH
43502-9452
US

V. Phone/Fax

Practice location:
  • Phone: 419-636-1713
  • Fax: 419-445-1401
Mailing address:
  • Phone: 419-445-1552
  • Fax: 419-445-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: