Individual
BENJAMIN LUKE LARISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHC-LP
Contact information
Practice address
579 COURTLANDT AVE, BRONX, NY 10451-5013
(718) 485-2100
Mailing address
413 E 114TH ST APT 4D, NEW YORK, NY 10029-2330
(319) 310-3432
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P120899
NY
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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