Provider Demographics
NPI:1083995781
Name:MEYER, BENJAMIN ABEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ABEL
Last Name:MEYER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 W 192ND ST APT 2M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2441
Mailing Address - Country:US
Mailing Address - Phone:347-768-3909
Mailing Address - Fax:
Practice Address - Street 1:786 GRANGE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4237
Practice Address - Country:US
Practice Address - Phone:347-768-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058005001041C0700X
PACW0216931041C0700X
1041C0700X
NY0827211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical