Daniel Stephen Benveniste, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60196503 Issued in WA

Practice address

1450 114TH Ave SE Ste 105
Bellevue, WA 98004-6934

Phone

(425) 455-0882

NPI assigned

Mar 24, 2011

Last updated

Jun 17, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 7, 2024 through Jun 7, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daniel Benveniste

  • Clinical Psychologist
  • Bellevue, WA
  • NPI 1063851244
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1003115429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4096 173RD PL SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980085928",
            "telephone_number": "425-455-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 114TH AVE SE STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046934",
            "telephone_number": "425-455-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENVENISTE",
        "first_name": "DANIEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60196503",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen Takashi Bennion
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• Andrea Miles Benshachar, S.L.P.
• Emmakay Benske
• Susan Bentsen, R.N.
• Kenji Grant Beppu, DDS, MSD
• Maureen S Berberian, DNP, ACNPC-BC
• Cindy Berg, LMHC
• Laci Berg, LMP
• Lena Berg

• Clinical Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.