Provider Demographics
NPI:1114754660
Name:BENTON, HANNAH ALYSE (LMSW)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ALYSE
Last Name:BENTON
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 1:566 7TH AVE RM 401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-1848
Mailing Address - Country:US
Mailing Address - Phone:212-564-7631
Mailing Address - Fax:
Practice Address - Street 1:566 7TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-1802
Practice Address - Country:US
Practice Address - Phone:212-564-7631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124938-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker