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General NPI Number Information
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NPI Number | 1639876584
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Entity Type | Organization
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Legal Business Name | BENJAMIN GOITZ MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 125 ADAMS ST STE 1
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City | DELMAR
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State | NY
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Zip | 12054-3211
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Country | US
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Telephone | 518-407-3291
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Fax | 518-475-9846
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Provider Business Mailing Address
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Address Line | 109 BEVERWYCK DR APT 9
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City | GUILDERLAND
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State | NY
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Zip | 12084-9678
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Country | US
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Telephone | 518-526-4126
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Fax |
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Authorized Official
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Title or Position | LMHC/OWNER
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Name | MR. BENJAMIN LIBRO GOITZ
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Credential | LMHC
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Telephone | 518-407-3291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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