Provider Demographics
NPI:1093422735
Name:PAPA, BENEDETTO JOHN JR (MA, MSOL, CASAC ADV)
Entity type:Individual
Prefix:MR
First Name:BENEDETTO
Middle Name:JOHN
Last Name:PAPA
Suffix:JR
Gender:M
Credentials:MA, MSOL, CASAC ADV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 SEMINARY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-1921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 SEMINARY HILL RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1921
Practice Address - Country:US
Practice Address - Phone:845-225-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY101YA0400X
NY37886101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)