Provider Demographics
NPI:1447843065
Name:BHADHA, BENAIFER (LCSW)
Entity type:Individual
Prefix:
First Name:BENAIFER
Middle Name:
Last Name:BHADHA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 18TH ST PH 901
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7518
Mailing Address - Country:US
Mailing Address - Phone:203-536-4617
Mailing Address - Fax:
Practice Address - Street 1:181 18TH ST PH 901
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-7518
Practice Address - Country:US
Practice Address - Phone:203-536-4617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090862-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical