Provider Demographics
NPI:1255154134
Name:BENSCOTER, ANNIE (LICSW)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:BENSCOTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:BROUWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1428
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-1428
Mailing Address - Country:US
Mailing Address - Phone:509-946-1430
Mailing Address - Fax:509-946-1432
Practice Address - Street 1:1124 STEVENS DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3360
Practice Address - Country:US
Practice Address - Phone:509-946-1430
Practice Address - Fax:509-946-1432
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC616090491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical