Clancy, Benjamin
Clancy, Benjamin is an sole proprietor health care provider with primary practice located at 4989 North 3Rd Street , Laramie WY 82072-9548. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Clancy, Benjamin can be contacted via phone (307) 745-8997.Contact Information
Primary practice address
4989 North 3Rd Street
Laramie WY 82072-9548
Phone: (307) 745-8997
Fax: (307) 742-6146
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | PPC-834 | Wyoming |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC-1564 | Wyoming |
Profile Details
| NPI number | 1215343934 |
|---|---|
| LBN Legal business name | Clancy, Benjamin |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 2nd, 2014 |
| Last updated | May 23rd, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215343934 | NPPES |
| Wyoming | Other | PPC-834 | MENTAL HEALTH PROFESSIONS LICENSING BOARD |
| Wyoming | Other | LPC-1564 | MENTAL HEALTH PROFESSIONS LICENSING BOARD |
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