Healthcare Provider Details

I. General information

NPI: 1598442394
Provider Name (Legal Business Name): BENJAMEN SAENZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 EDMISTON WAY STE 204
BUCKHANNON WV
26201-8916
US

IV. Provider business mailing address

101 PEMBROKE CT
GREENSBURG PA
15601-6404
US

V. Phone/Fax

Practice location:
  • Phone: 304-476-7751
  • Fax:
Mailing address:
  • Phone: 724-396-1510
  • Fax: 724-972-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3065
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: