Active NPI
Laura Sheffield Bennett, PH.D.
- Clinical Child & Adolescent Psychologist
- Portland, OR
National Provider Identifier
1043422413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 1678
- Practice address
- 8401 NE Halsey St
Suite 203
Portland, OR 97220-5670 - Phone
- (503) 977-0400
- Fax
- (208) 248-0977
- NPI assigned
- May 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1678 | OR | Primary |
Addresses
Primary practice location
8401 NE Halsey St
Suite 203
Portland, OR 97220-5670
Mailing address
8401 NE Halsey St
Suite 203
Portland, OR 97220-5670
Phone (503) 977-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 026862 | Other | OR | OMAP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1678 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254268800000",
"number": "1043422413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 NE HALSEY ST",
"address_2": "SUITE 203",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972205670",
"telephone_number": "503-977-0400",
"fax_number": "208-248-0977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 NE HALSEY ST",
"address_2": "SUITE 203",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972205670",
"telephone_number": "503-977-0400",
"fax_number": "208-248-0977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "LAURA",
"middle_name": "SHEFFIELD",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-05",
"last_updated": "2009-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OR",
"license": "1678",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OMAP NUMBER",
"identifier": "026862",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.