Provider Demographics
NPI:1104691492
Name:FAROUQI, BENISH (LMSW)
Entity type:Individual
Prefix:
First Name:BENISH
Middle Name:
Last Name:FAROUQI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 HAKES RD
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-7153
Mailing Address - Country:US
Mailing Address - Phone:718-406-5745
Mailing Address - Fax:
Practice Address - Street 1:1325 HAKES RD
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-7153
Practice Address - Country:US
Practice Address - Phone:718-406-5745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087955104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker