Provider Demographics
NPI:1831956267
Name:BENSON, AMANDA (LSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 BEATTY RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1334
Mailing Address - Country:US
Mailing Address - Phone:412-502-5747
Mailing Address - Fax:
Practice Address - Street 1:560 BEATTY RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1334
Practice Address - Country:US
Practice Address - Phone:412-374-8275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132605104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker