Basic Information
| Provider Information | |||||||||
| NPI: | 1568781847 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 CRANBERRY CT | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170468120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176732734 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 618 CUMBERLAND ST | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170425232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172742741 | ||||||||
| FaxNumber: | 7172745405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2010 | ||||||||
| LastUpdateDate: | 06/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 6588 | OH | N | Behavioral Health & Social Service Providers | Psychologist | 103T00000X | PS017123 | PA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.