Provider Demographics
NPI:1063023976
Name:BENDER, KARLY (LCSW)
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 W 8TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4543
Mailing Address - Country:US
Mailing Address - Phone:814-546-3155
Mailing Address - Fax:
Practice Address - Street 1:2220 W 8TH ST STE 1
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4543
Practice Address - Country:US
Practice Address - Phone:814-546-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2025-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0250371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1174962435OtherUPMC