Provider Demographics
NPI:1942745567
Name:HELLER, BEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:
Last Name:HELLER
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 1:74 PARSONS DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1308
Mailing Address - Country:US
Mailing Address - Phone:860-997-9864
Mailing Address - Fax:
Practice Address - Street 1:998 FARMINGTON AVE STE 207
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2184
Practice Address - Country:US
Practice Address - Phone:860-997-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0072251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical