Individual
BENJAMIN MCCORMACK
Active
Individual
BENJAMIN MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
098010
NY
1041C0700X
Clinical Social Worker
Primary
089257
NY
Other
Enumeration date
09/27/2017
Last updated
12/14/2021
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