Individual
BENJAMIN MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6303 W 63RD ST UNIT 3C, CHICAGO, IL 60638-7015
(773) 993-8389
Mailing address
6303 W 63RD ST UNIT 3C, CHICAGO, IL 60638-7015
(773) 993-8389
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149027148
IL
174400000X
Specialist
—
—
Other
Enumeration date
06/29/2019
Last updated
06/21/2024
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