Provider Demographics
NPI:1184165052
Name:WOOD, BENJAMIN MORGAN (LCSW, CSAC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MORGAN
Last Name:WOOD
Suffix:
Gender:M
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 W MAIN ST STE 202A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4687
Mailing Address - Country:US
Mailing Address - Phone:804-362-8068
Mailing Address - Fax:
Practice Address - Street 1:517 W GRACE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4911
Practice Address - Country:US
Practice Address - Phone:804-783-2505
Practice Address - Fax:804-649-1635
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102866101YA0400X
VA0904011565101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)