Provider Demographics
NPI:1386036226
Name:SARAH J BENSON
Entity Type:Organization
Organization Name:SARAH J BENSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-646-2853
Mailing Address - Street 1:1000 JACKS RUN RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:NORTH VERSAILLES
Mailing Address - State:PA
Mailing Address - Zip Code:15137-2744
Mailing Address - Country:US
Mailing Address - Phone:412-646-2853
Mailing Address - Fax:412-646-2876
Practice Address - Street 1:1000 JACKS RUN RD
Practice Address - Street 2:SUITE G
Practice Address - City:NORTH VERSAILLES
Practice Address - State:PA
Practice Address - Zip Code:15137-2744
Practice Address - Country:US
Practice Address - Phone:412-646-2853
Practice Address - Fax:412-646-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9876544578Medicare PIN