Benjamin Laliberte, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3262 Issued in OR

Practice address

2870 NE West Devils Lake Rd
Lincoln City, OR 97367-5127

Phone

(541) 994-9191

NPI assigned

Oct 15, 2018

Last updated

Nov 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: blaliberte192529@samhealth.direct-ci.com

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1023584398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1194",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 NE WEST DEVILS LAKE RD",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675127",
            "telephone_number": "541-994-9191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8303 Platt Rd",
            "address_purpose": "LOCATION",
            "city": "Saline",
            "state": "MI",
            "postal_code": "481769773",
            "country_code": "US",
            "telephone_number": "734-295-4616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALIBERTE",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-15",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3262",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "6301017255",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blaliberte192529@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "2870 NE West Devils Lake Rd",
            "city": "Lincoln City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973675127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychologist in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.