Provider Demographics
NPI:1720689391
Name:BENJAMIN FERRIS, LCSW
Entity Type:Organization
Organization Name:BENJAMIN FERRIS, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-470-1186
Mailing Address - Street 1:26 COURT ST STE 1009
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-1110
Mailing Address - Country:US
Mailing Address - Phone:917-924-2897
Mailing Address - Fax:
Practice Address - Street 1:26 COURT ST STE 1009
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1110
Practice Address - Country:US
Practice Address - Phone:917-924-2897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health