Provider Demographics
NPI:1881142131
Name:VANROY, BENJAMIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:VANROY
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 1:16 TERRACE PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3012
Mailing Address - Country:US
Mailing Address - Phone:310-795-5968
Mailing Address - Fax:
Practice Address - Street 1:16 TERRACE PL
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3012
Practice Address - Country:US
Practice Address - Phone:310-795-5968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW79169101YM0800X
NY0917181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health