Provider Demographics
NPI:1417595539
Name:GREENWALD, BENJAMIN COOPER (LMHC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:COOPER
Last Name:GREENWALD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 WINDSOR HWY # 442
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7900
Mailing Address - Country:US
Mailing Address - Phone:845-532-7027
Mailing Address - Fax:
Practice Address - Street 1:367 WINDSOR HWY STE 442
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7900
Practice Address - Country:US
Practice Address - Phone:845-532-7027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health