Provider Demographics
NPI:1083712616
Name:BENJAMIN, BARI (LCSW,BCD)
Entity Type:Individual
Prefix:MS
First Name:BARI
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:LCSW,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 S BRADDOCK AVE
Mailing Address - Street 2:SUITE 301 C
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1262
Mailing Address - Country:US
Mailing Address - Phone:412-243-5660
Mailing Address - Fax:
Practice Address - Street 1:5743 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1515
Practice Address - Country:US
Practice Address - Phone:412-422-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0135961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA124695OtherVALUE OPTIONS
PA636730OtherHIGHMARK BC/BS
PA124695OtherVALUE OPTIONS
PA636730OtherHIGHMARK BC/BS