Active NPI
Judith Ann Bensinger Haynes, MED, MA, LMFT 114669
- Counseling Psychologist
- Lafayette, CA
National Provider Identifier
1083218804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 114669
- Practice address
- 954 Risa Rd Ste a
Lafayette, CA 94549-3418 - Phone
- (925) 683-3274
- NPI assigned
- Nov 23, 2020
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 114669 | CA | Primary |
Addresses
Primary practice location
954 Risa Rd Ste a
Lafayette, CA 94549-3418
Mailing address
954 Risa Rd Ste a
Lafayette, CA 94549-3418
Phone (925) 683-3274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts, Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114669 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1083218804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "954 RISA RD STE A",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493418",
"telephone_number": "925-683-3274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "954 RISA RD STE A",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493418",
"telephone_number": "925-683-3274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSINGER HAYNES",
"first_name": "JUDITH",
"middle_name": "ANN",
"credential": "MED, MA, LMFT 114669",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "114669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.