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BENJAMIN CLOVER LPCC
NPI 1073294104
Counselor - Professional in Diamond Springs, CA

Active since July 31, 2023PECOS Enrolled
4250 FOWLER LN STE 204, DIAMOND SPRINGS, CA 95619(530) 626-3105 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Benjamin Clover Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN CLOVER LPCC (NPI 1073294104) is an individual professional provider in Diamond Springs, California, licensed in California (14202) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1073294104
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameBENJAMIN CLOVERCredential: LPCC
Location Address4250 FOWLER LN STE 204Diamond Springs, CA 95619-9782
Mailing Address3647 Jenny Lind AveNorth Highlands, CA 95660-5609
Phone(530) 626-3105
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 31, 2023
Last NPPES UpdateFebruary 2, 2026
NPPES CertifiedFebruary 2, 2026
✔ NPI 1073294104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in CA · 14202
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 14202 (CA)
4250 FOWLER LN STE 204, Diamond Springs, CA 95619
Open in Google Maps ↗

Other Names 1

Former Name (1)Benjamin Saubolle-camacho

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Benjamin Clover Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294216206
PECOS Enrollment IDI20260226002935
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Benjamin Clover reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PC
111 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HANNAH FLYNN
Case Manager/Care Coordinator
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (530) 626-3105
KATHLEEN HACKER
Case Manager/Care Coordinator
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (530) 626-3105
ASHLEY CHRISTINE MCCULLOCH
Marriage & Family Therapist
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (949) 370-4667
JAZMIN RAMIREZ
Case Manager/Care Coordinator
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (530) 626-3105
HANNAH JONES BSW
Student in an Organized Health Care Education/Training Program
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (949) 680-9103
SHANNON SPICER
Marriage & Family Therapist
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (530) 295-1491
DENISE KALAR LMFT
Marriage & Family Therapist
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (530) 626-3105
GABRIELLE KENNGOTT
Marriage & Family Therapist
4250 FOWLER LN STE 204
DIAMOND SPRINGS, CA 95619
El Dorado County (415) 713-0605

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Clover's NPI number?

The NPI number for Benjamin Clover is 1073294104. It was assigned to this individual provider in the NPPES registry on July 31, 2023. The provider is also known as Benjamin Saubolle-Camacho.

Where is Benjamin Clover located?

Benjamin Clover practices at 4250 Fowler Ln Ste 204, Diamond Springs, CA 95619. The listed phone number is (530) 626-3105.

What is Benjamin Clover's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Benjamin Clover enrolled in Medicare?

Yes. Benjamin Clover is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Benjamin Clover's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Clover reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Benjamin Clover's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Benjamin Clover was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.