Provider Demographics
NPI:1528284098
Name:BENSON, LINDA ROSEANN (LPC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ROSEANN
Last Name:BENSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MULLEN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640
Mailing Address - Country:US
Mailing Address - Phone:570-602-7753
Mailing Address - Fax:570-602-7754
Practice Address - Street 1:341 WYOMING AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:WEST PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18643
Practice Address - Country:US
Practice Address - Phone:570-883-9020
Practice Address - Fax:570-602-7754
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional