Provider Demographics
NPI:1598117772
Name:BENSON, TARA
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 HARLEM RD STE 13
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4746
Mailing Address - Country:US
Mailing Address - Phone:716-446-4168
Mailing Address - Fax:716-446-4140
Practice Address - Street 1:3960 HARLEM RD STE 13
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4746
Practice Address - Country:US
Practice Address - Phone:716-446-4168
Practice Address - Fax:716-446-4140
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor