Provider Demographics
NPI:1356802219
Name:LATNER, BENJAMIN H (MSW, LCSW, LCADC)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:H
Last Name:LATNER
Suffix:
Gender:M
Credentials:MSW, LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 W CENTURY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1466
Mailing Address - Country:US
Mailing Address - Phone:201-783-3398
Mailing Address - Fax:
Practice Address - Street 1:53 FIELD RD
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1502
Practice Address - Country:US
Practice Address - Phone:201-783-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1323101YA0400X
NJ37LC00269300101YA0400X
NJ44SC058190001041C0700X
CT105421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)