Susan Ariana Tarisa Benham
Social Worker in South Lake Tahoe, CA. Individual provider (NPI-1).
NPI number1154065639
StatusActive
Last updated in NPPESJun 30, 2023
Details
- NPI
- 1154065639
- Entity type
- Individual (NPI-1)
- Name
- Susan Ariana Tarisa Benham
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 21, 2022
- Certification date
- Jun 30, 2023
- Last updated
- Jun 30, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | ASW107313 | CA | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
1900 Lake Tahoe BlvdSouth Lake Tahoe, CA 96150-6305
Phone 530-318-4824
Mailing address
1900 Lake Tahoe BlvdSouth Lake Tahoe, CA 96150-6305
Phone 530-318-4824
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Social Worker providers in South Lake Tahoe, CA
- Cheryl Marie Frawley, MSWNPI 1558890699
- Jennifer Ann FullerNPI 1700682341
- Heather Lynn ShookNPI 1720893175
- Nicole Marie Vandehurst, MANPI 1316578701
All 5 Social Worker providers in South Lake Tahoe · All 712 providers in South Lake Tahoe
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