Provider Demographics
NPI:1346427093
Name:CRAVENS, BENJAMIN LEE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:LEE
Last Name:CRAVENS
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 1:1627 HWY 62/412
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542
Mailing Address - Country:US
Mailing Address - Phone:870-897-6974
Mailing Address - Fax:870-856-2768
Practice Address - Street 1:2423 W HWY 62/412
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542
Practice Address - Country:US
Practice Address - Phone:870-257-0033
Practice Address - Fax:870-856-2768
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARM-1978101YM0800X
AR2324-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health