Provider Demographics
NPI:1326752023
Name:BENJAMIN, OMEKA (LMSW)
Entity Type:Individual
Prefix:
First Name:OMEKA
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:OMEKA
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1512 ARCADIA BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-2913
Mailing Address - Country:US
Mailing Address - Phone:803-720-6659
Mailing Address - Fax:
Practice Address - Street 1:1512 ARCADIA BLUFF DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-2913
Practice Address - Country:US
Practice Address - Phone:803-720-6659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC153321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical