Individual provider Active NPI

Clarice M Benjamin, MS., CCC/SLP

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1487799862
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP2099 Issued in AZ
Practice address
6238 E Palm St
Mesa, AZ 85215-1558
Phone
(602) 321-9959
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP2099 AZ Primary

Addresses

Primary practice location

6238 E Palm St
Mesa, AZ 85215-1558

Mailing address

6238 E Palm St
Mesa, AZ 85215-1558
Phone (602) 321-9959

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 Science

State licenses

LicenseStateTypeSpecialty
SLP2099AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1487799862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6238 E PALM ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151558",
            "telephone_number": "602-321-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6238 E PALM ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151558",
            "telephone_number": "602-321-9959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "CLARICE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MS., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP2099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.