MEDICARE: MR. BENJAMIN P MEADE MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	L5748	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841424538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN P MEADE MSW, LCSW

Provider Business Mailing Address
First Line	:	36 SW NYE ST
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-3821
Country	:	US
Telephone Number	:	541-265-0445
Fax Number	:

Provider Business Practice Location Address
First Line	:	4422 NE DEVILS LAKE BLVD
Second Line	:	SUITE 2
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-5000
Country	:	US
Telephone Number	:	541-265-4196
Fax Number	:	541-994-1882

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	06/04/2020

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