Provider Demographics
NPI:1942339601
Name:POPE, BENJAMIN JEREMIAH (MA)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:JEREMIAH
Last Name:POPE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:BEN BJ
Other - Middle Name:
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:81402
Mailing Address - Country:US
Mailing Address - Phone:970-252-3200
Mailing Address - Fax:970-252-3208
Practice Address - Street 1:605 E MIAMI RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-249-9694
Practice Address - Fax:970-219-2955
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)