Provider Demographics
NPI:1871141903
Name:CRAMER, BENJAMIN STOVALL (LCSW)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:STOVALL
Last Name:CRAMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-513 KAMAHAO PL APT A
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2425
Mailing Address - Country:US
Mailing Address - Phone:541-543-4410
Mailing Address - Fax:
Practice Address - Street 1:1195A CITY VIEW ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3325
Practice Address - Country:US
Practice Address - Phone:541-342-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW5148101YM0800X, 1041C0700X
ORL11690101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health