Provider Demographics
NPI:1275837726
Name:ESTEVEZ, BENERO ANTHONY (LMSW)
Entity Type:Individual
Prefix:
First Name:BENERO
Middle Name:ANTHONY
Last Name:ESTEVEZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 CROTON LOOP
Mailing Address - Street 2:APT. 4C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-1516
Mailing Address - Country:US
Mailing Address - Phone:718-942-0216
Mailing Address - Fax:
Practice Address - Street 1:2857 LINDEN BOUELVARD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208
Practice Address - Country:US
Practice Address - Phone:718-235-3100
Practice Address - Fax:718-277-0822
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082878104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker