Individual provider Active NPI

Benjamin Morgan Hendrickson, PSY.D

  • Clinical Psychologist
  • Columbus, OH
National Provider Identifier
1427401660
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7360 Issued in OH
Practice address
2200 W Broad St
Columbus, OH 43223-1297
Phone
(614) 752-0333
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7360 OH Primary

Addresses

Primary practice location

2200 W Broad St
Columbus, OH 43223-1297

Mailing address

2200 W Broad St
Columbus, OH 43223-1297
Phone (614) 752-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160831001673 OH Practitioner - Clinical Psychologist 2062708035 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7360OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients

Locations

2200 W Broad St
Columbus, OH 43223

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1427401660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432231297",
            "telephone_number": "614-752-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432231297",
            "telephone_number": "614-752-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "BENJAMIN",
        "middle_name": "MORGAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.