Individual
BENJAMIN KYLE HANCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3810-3 WILLIAMSBURG PARK BLVD, JACKSONVILLE, FL 32257-9220
(904) 419-6102
(904) 739-2153
Mailing address
3810-3 WILLIAMSBURG PARK BLVD, JACKSONVILLE, FL 32257-9220
(904) 419-6102
(904) 739-2153
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW16191
FL
1041C0700X
Clinical Social Worker
Primary
SW16191
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW16191
LICENSE NUMBER
FL
Enumeration date
03/25/2020
Last updated
02/03/2022
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