Provider Demographics
NPI:1275337693
Name:HANNA, BENJAMIN (LMSW)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:HANNA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 S MANHEIM BLVD APT 38
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2464
Mailing Address - Country:US
Mailing Address - Phone:917-697-7859
Mailing Address - Fax:
Practice Address - Street 1:21 S CHESTNUT ST STE 103
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1944
Practice Address - Country:US
Practice Address - Phone:845-202-3138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085919104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker