Bradley David Benedict, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042296A Issued in IN

Practice address

4500 S Lancaster Rd
Dallas, TX 75216-7167

Phone

(214) 857-0523

Fax

(214) 857-0531

NPI assigned

Nov 28, 2008

Last updated

Nov 28, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227830400000",
    "number": "1013162379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 SARA JANE PKWY APT 332",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528604",
            "telephone_number": "214-857-0523",
            "fax_number": "214-857-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-0523",
            "fax_number": "214-857-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "BRADLEY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-28",
        "last_updated": "2008-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042296A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Murdoch Bender, PA-C
• Katherine Christine Bender
• Norman Howard Bender, BS,RPH
• Steven D Bender, D.D.S.
• Audrey Ann Benedict
• Brooke Benedict
• Jubilee Hope Benedict
• Beneficial Home Healthcare Services Inc
• Lauren Michelle Benefield, MSN, APRN, FNP-C
• Amanda R. Beneke, M.S.

• Clinical Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.