Active NPI
Sarah Wildermuth Benton, PSY.D.
- Clinical Psychologist
- Richmond, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004207
- Practice address
- 2924 Brook Rd
Children's Hospital
Richmond, VA 23220-1215 - Phone
- (804) 321-7474
- Fax
- (804) 228-5210
- NPI assigned
- Oct 21, 2008
- Last updated
- Sep 20, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004207 | VA | Primary |
| Clinical Psychologist | 103TC0700X | 09-19P | AR |
Addresses
Primary practice location
2924 Brook Rd
Children's Hospital
Richmond, VA 23220-1215
Mailing address
2924 Brook Rd
Children's Hospital Credentialing Dept
Richmond, VA 23220-1215
Phone (804) 321-7474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2924 Brook Rd
Richmond, VA 23220-1215
Phone (804) 321-7474
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09-19P | AR | MD | Clinical Psychologist |
| 0810004207 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCV Associated Physicians | Current | Accepting new patients |
Locations
2924 Brook Rd
Richmond, VA 23220
Phone (804) 321-7474
401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409
Interoperability endpoints
- commonwealthcounselingassociates.sarahwbenton@134000.advancedmd-direct.com
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": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1174775290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2924 BROOK RD",
"address_2": "CHILDREN'S HOSPITAL CREDENTIALING DEPT",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232201215",
"telephone_number": "804-321-7474",
"fax_number": "804-228-5210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2924 BROOK RD",
"address_2": "CHILDREN'S HOSPITAL",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232201215",
"telephone_number": "804-321-7474",
"fax_number": "804-228-5210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON",
"first_name": "SARAH",
"middle_name": "WILDERMUTH",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004207",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "09-19P",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.