Individual
COREY D BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC, CRM, QMHA
Contact information
Practice address
3800 SW CEDAR HILLS BLVD STE 170, BEAVERTON, OR 97005-2020
(503) 626-1800
Mailing address
3800 SW CEDAR HILLS BLVD STE 170, BEAVERTON, OR 97005-2020
(503) 626-1800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-2156
OR
101YM0800X
Mental Health Counselor
23-QMHA-R-4572
OR
175T00000X
Peer Specialist
23-CRM-2525
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-CRM-2525
MHACBO CRM
OR
01
—
23-QMHA-R-4572
MHACBO QMHA
OR
05
—
500841524
—
OR
01
—
T-22-2156
MHACBO CADC
OR
Enumeration date
11/01/2023
Last updated
11/28/2024
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