Provider Demographics
NPI:1912876509
Name:GOLDSTEIN, BENJAMIN KANE (LCSW)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KANE
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 UPLAND RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1822
Mailing Address - Country:US
Mailing Address - Phone:215-805-0665
Mailing Address - Fax:
Practice Address - Street 1:1062 E LANCASTER AVE STE 15G
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1565
Practice Address - Country:US
Practice Address - Phone:215-318-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-01
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0264341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical