Active NPI
David S Bennett, PHD
- Psychologist
- Philadelphia, PA
National Provider Identifier
1194962423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS006349L
- Practice address
- 230 N Broad St
Philadelphia, PA 19102-1121 - Phone
- (215) 762-7963
- NPI assigned
- Jan 8, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS006349L | PA | Primary |
Addresses
Primary practice location
230 N Broad St
Philadelphia, PA 19102-1121
Mailing address
4641 Roosevelt Blvd
Friends Hospital, Suite C229
Philadelphia, PA 19124-2343
Phone (215) 831-4811
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 |
|---|---|---|---|
| PS006349L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1194962423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4641 ROOSEVELT BLVD",
"address_2": "FRIENDS HOSPITAL, SUITE C229",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191242343",
"telephone_number": "215-831-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021121",
"telephone_number": "215-762-7963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "DAVID",
"middle_name": "S",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-08",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS006349L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.