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General NPI Number Information
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NPI Number | 1609272996
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Entity Type | Individual
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Provider Name | YECHIEL BENEDIKT LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 5309 18TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-1523
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Country | US
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Telephone | 848-223-3804
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Fax |
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Provider Business Mailing Address
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Address Line | 665 PRINCETON AVE APT 403
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2977
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Country | US
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Telephone | 732-942-7527
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 086195
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05738200
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License Number State | NJ
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