Provider Demographics
NPI:1578711297
Name:YAROCH, BENJAMIN JAMES (MSW, LCSW, ACSW)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:JAMES
Last Name:YAROCH
Suffix:
Gender:M
Credentials:MSW, LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 CHARLOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2757
Mailing Address - Country:US
Mailing Address - Phone:724-861-5615
Mailing Address - Fax:
Practice Address - Street 1:171 CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2757
Practice Address - Country:US
Practice Address - Phone:724-861-5615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-06
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical