Provider Demographics
NPI:1386365906
Name:BENJAMIN PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BENJAMIN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:570-221-5165
Mailing Address - Street 1:1731 LERMOOS CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8622
Mailing Address - Country:US
Mailing Address - Phone:570-221-5165
Mailing Address - Fax:516-407-5397
Practice Address - Street 1:3477 CORPORATE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8237
Practice Address - Country:US
Practice Address - Phone:570-221-5165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty