Stephanie Benson, PSYD
Individual provider Active NPI Clinical Psychologist · Washington, DC
NPI 1316625445 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1316625445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0810008209 (VA)
- Practice address
- 600 Pennsylvania Ave SE Ste 340
Washington, DC 20003-6300 - Phone
- (571) 328-7408
- NPI assigned
- Jul 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 11, 2023 through Aug 11, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810008209 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mind Body Health LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810008209 | VA | Yes |
Addresses
Primary practice location
600 Pennsylvania Ave SE Ste 340
Washington, DC 20003-6300
Mailing address
1001 4TH St SW Apt 330
Washington, DC 20024-4571
Phone (917) 566-2301
Other providers in Washington, DC
- Mary R Benson
- Nafatia Noel Benson
- Richard T Benson
- Sharon Benson
- Sherrell Benson
- Katherine N Bent
- Jacqueline Margo Bentham
- Darla S Benton
- Joston Benton
- Kerry Ryan Benton
All providers in Washington, DC · Clinical Psychologist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.