Provider Demographics
NPI:1104196070
Name:KRASNICK, BENJAMIN SILIN (LICSW)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:SILIN
Last Name:KRASNICK
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 LEXINGTON ST STE 202-4
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-1387
Mailing Address - Country:US
Mailing Address - Phone:978-795-4122
Mailing Address - Fax:
Practice Address - Street 1:430 MCGRATH HWY
Practice Address - Street 2:#2
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1930
Practice Address - Country:US
Practice Address - Phone:978-549-3364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical