Provider Demographics
NPI:1831714104
Name:BENJAMIN, ROBERT PATRICK (LMSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WALTON AVE STE 2N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5416
Mailing Address - Country:US
Mailing Address - Phone:718-860-1656
Mailing Address - Fax:718-860-1657
Practice Address - Street 1:250 WALTON AVE STE 2N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5416
Practice Address - Country:US
Practice Address - Phone:718-860-1656
Practice Address - Fax:718-860-1657
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0986241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical