Provider Demographics
NPI:1134580426
Name:ERIK R. BENSON, LCSW, INC.
Entity type:Organization
Organization Name:ERIK R. BENSON, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:847-361-9768
Mailing Address - Street 1:1440 RENAISSANCE DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1356
Mailing Address - Country:US
Mailing Address - Phone:847-361-9768
Mailing Address - Fax:847-297-0007
Practice Address - Street 1:1440 RENAISSANCE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1356
Practice Address - Country:US
Practice Address - Phone:847-361-9768
Practice Address - Fax:847-297-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty