Provider Demographics
NPI:1780868232
Name:BEBENEK, CAROL (LPC; RN,C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BEBENEK
Suffix:
Gender:F
Credentials:LPC; RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 RINGTOWN MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CATAWISSA
Mailing Address - State:PA
Mailing Address - Zip Code:17820-8647
Mailing Address - Country:US
Mailing Address - Phone:570-799-5489
Mailing Address - Fax:
Practice Address - Street 1:935 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1243
Practice Address - Country:US
Practice Address - Phone:570-276-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional