=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396078325
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BENJAMIN ABRAM HINDELL LMSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2009
-----------------------------------------------------
Last Update Date | 07/28/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3225 TEMPLETON GAP RD STE 214
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80907-8714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-948-6789
-----------------------------------------------------
Fax | 877-345-3501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13945 RIVERCREST CIR
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80921-3217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-984-2316
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW.09923207
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------