Provider Demographics
NPI:1780633461
Name:BENJAMIN, STEVEN JOHN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOHN
Last Name:BENJAMIN
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 1:389A W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1232
Mailing Address - Country:US
Mailing Address - Phone:585-343-2396
Mailing Address - Fax:585-343-2396
Practice Address - Street 1:389A W MAIN ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1232
Practice Address - Country:US
Practice Address - Phone:585-343-2396
Practice Address - Fax:585-343-2396
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0397181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical