Provider Demographics
NPI:1992520894
Name:BENJAMIN, RIVKA (LCSW)
Entity type:Individual
Prefix:
First Name:RIVKA
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:RIVKA
Other - Middle Name:
Other - Last Name:HERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2939 HARTZELL ST
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3036
Mailing Address - Country:US
Mailing Address - Phone:973-714-9813
Mailing Address - Fax:
Practice Address - Street 1:605 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2420
Practice Address - Country:US
Practice Address - Phone:973-714-9813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0278461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical