Active NPI
Elliott Benay, MA
- Psychologist
- Jericho, VT
National Provider Identifier
1376537860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 047-0000024
- Practice address
- 85 Alpine Dr
Jericho, VT 05465-2071 - Phone
- (802) 899-3558
- Fax
- (802) 899-1726
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 047-0000024 | VT | Primary |
Addresses
Primary practice location
85 Alpine Dr
Jericho, VT 05465-2071
Mailing address
85 Alpine Dr
Jericho, VT 05465-2071
Phone (802) 899-3558
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006534 | Medicaid | VT |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047-0000024 | VT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206576000000",
"number": "1376537860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 ALPINE DR",
"city": "JERICHO",
"state": "VT",
"postal_code": "054652071",
"telephone_number": "802-899-3558",
"fax_number": "802-899-1726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 ALPINE DR",
"city": "JERICHO",
"state": "VT",
"postal_code": "054652071",
"telephone_number": "802-899-3558",
"fax_number": "802-899-1726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENAY",
"first_name": "ELLIOTT",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2008-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "047-0000024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006534",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jericho, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.