Provider Demographics
NPI:1821711326
Name:NEFF, BENJAMIN S II (EDS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:S
Last Name:NEFF
Suffix:II
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-4721
Mailing Address - Country:US
Mailing Address - Phone:304-363-7323
Mailing Address - Fax:304-366-2483
Practice Address - Street 1:445 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2843
Practice Address - Country:US
Practice Address - Phone:304-363-7323
Practice Address - Fax:304-366-2483
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVE9A146900189103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool