Provider Demographics
NPI:1245620996
Name:HALPERN, BENJAMIN (LCSW)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:HALPERN
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 1:500 W KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1254
Mailing Address - Country:US
Mailing Address - Phone:732-730-3900
Mailing Address - Fax:732-730-3900
Practice Address - Street 1:500 W KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1254
Practice Address - Country:US
Practice Address - Phone:732-730-3900
Practice Address - Fax:732-730-3900
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056087001041C0700X
NY0838981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical