Provider Demographics
NPI:1760139521
Name:BENJAMIN, JESSICA H (MSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:H
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3110
Mailing Address - Country:US
Mailing Address - Phone:134-778-3467
Mailing Address - Fax:
Practice Address - Street 1:356 E 45TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3110
Practice Address - Country:US
Practice Address - Phone:134-778-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health