Provider Demographics
NPI:1598827198
Name:HEMMING, BENJAMIN MEIKLE (LCSW, LICSW)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MEIKLE
Last Name:HEMMING
Suffix:
Gender:M
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 ITANI DR
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-9671
Mailing Address - Country:US
Mailing Address - Phone:801-857-8033
Mailing Address - Fax:
Practice Address - Street 1:1240 SE BISHOP BLVD STE Q
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5439
Practice Address - Country:US
Practice Address - Phone:801-857-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6293597-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical