Provider Demographics
NPI:1134755259
Name:PROBST, BENJAMIN (LPC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:PROBST
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 UNITY CENTER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-1320
Mailing Address - Country:US
Mailing Address - Phone:412-715-8171
Mailing Address - Fax:
Practice Address - Street 1:2681 WADDINGTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-1758
Practice Address - Country:US
Practice Address - Phone:412-715-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional