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General NPI Number Information
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NPI Number | 1134580426
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Entity Type | Organization
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Legal Business Name | ERIK R. BENSON, LCSW, INC.
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 1440 RENAISSANCE DR SUITE 250
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City | PARK RIDGE
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State | IL
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Zip | 60068-1356
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Country | US
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Telephone | 847-361-9768
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Fax | 847-297-0007
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Provider Business Mailing Address
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Address Line | 1440 RENAISSANCE DR SUITE 250
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City | PARK RIDGE
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State | IL
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Zip | 60068-1356
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Country | US
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Telephone | 847-361-9768
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Fax | 847-297-0007
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MR. ERIK ROY BENSON
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Credential | MSW, LCSW
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Telephone | 847-361-9768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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