Individual provider Active NPI

Benna Z Sherman, PHD

  • Psychologist
  • Severna Park, MD
National Provider Identifier
1073639100
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2918 Issued in MD
Practice address
549 Charington Dr.
Severna Park, MD 21146
Phone
(410) 562-5141
Fax
(410) 544-4376
NPI assigned
Mar 21, 2007
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2918 MD Primary

Addresses

Primary practice location

549 Charington Dr.
Severna Park, MD 21146

Mailing address

549 Charington Dr.
Severna Park, MD 21146
Phone (410) 562-5141

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 16, 2014 through Nov 16, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2918MDMDPsychologist
02918MDMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
William D Petok, PHD, PA Psychologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1073639100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 CHARINGTON DR.",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21146",
            "telephone_number": "410-562-5141",
            "fax_number": "410-544-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 CHARINGTON DR.",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21146",
            "telephone_number": "410-562-5141",
            "fax_number": "410-544-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "BENNA",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "2918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.