Provider Demographics
NPI:1881739266
Name:CORTES, BENJAMIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:CORTES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:BENJAMIN
Other - Middle Name:
Other - Last Name:CORTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:6 FOX MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-2229
Mailing Address - Country:US
Mailing Address - Phone:508-421-3361
Mailing Address - Fax:
Practice Address - Street 1:340 MAIN ST
Practice Address - Street 2:SUITE 503
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1604
Practice Address - Country:US
Practice Address - Phone:508-926-0070
Practice Address - Fax:508-459-5340
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202044101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health