Individual
MR. BENJAMIN GIBBS KOHL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Contact information
Practice address
29520 CANVASBACK DR, EASTON, MD 21601-7124
(410) 822-5007
(410) 822-5569
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6960
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14686
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259147-000
MAGELLAN
MD
01
—
522156095
UNITED BEHAVIORAL HEALTH
MD
05
—
609550002
—
MD
05
—
609550005
—
MD
01
—
LM49EA
CAREFIRST BCBS LOCAL
MD
01
—
R968
CAREFIRST BCBS FEDERAL
MD
Enumeration date
01/12/2009
Last updated
09/20/2016
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