Active NPI
Mary Ashton Phillips-Benesh, PH.D
- Cognitive & Behavioral Psychologist
- Overland Park, KS
National Provider Identifier
1033474630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- LP03360
- Practice address
- 10555 Marty St Ste 100
Overland Park, KS 66212-2555 - Phone
- (913) 649-8820
- Fax
- (913) 649-8823
- NPI assigned
- Jul 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | LP03360 | KS | Primary |
Addresses
Primary practice location
10555 Marty St Ste 100
Overland Park, KS 66212-2555
Mailing address
10555 Marty St Ste 100
Overland Park, KS 66212-2555
Phone (913) 649-8820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 21, 2024 through Nov 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP03360 | KS | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1033474630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10555 MARTY ST STE 100",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662122555",
"telephone_number": "913-649-8820",
"fax_number": "913-649-8823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10555 MARTY ST STE 100",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662122555",
"telephone_number": "913-649-8820",
"fax_number": "913-649-8823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS-BENESH",
"first_name": "MARY",
"middle_name": "ASHTON",
"name_prefix": "Ms.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-10",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "KS",
"license": "LP03360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.