NPIMap

Organization Active NPI

Jennifer Benton, PHD, PLLC

  • Clinical Psychologist
  • Tulsa, OK
National Provider Identifier
1518211747
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1057 Issued in OK
Legal business name
JENNIFER BENTON, PHD, PLLC
Practice address
4815 S Harvard Ave
Suite 470
Tulsa, OK 74135-3055
Phone
(918) 392-4866
Fax
(918) 392-4867
NPI assigned
Nov 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Dr. Jennifer M Benton, PHDNPI 1609927219
Title
Psychologist
Phone
(918) 392-4866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1057 OK Primary

Addresses

Primary practice location

4815 S Harvard Ave
Suite 470
Tulsa, OK 74135-3055

Mailing address

4815 S Harvard Ave
Suite 470
Tulsa, OK 74135-3055
Phone (918) 392-4866

Other identifiers 1

IdentifierTypeStateIssuer
1609927219OtherOKINDIVIDUAL NPI# -TYPE I

National Provider Directory

National Provider Directory

Locations

4815 S Harvard Ave
Ste 470
Tulsa, OK 74135
Phone (918) 392-4866

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1518211747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 S HARVARD AVE",
            "address_2": "SUITE 470",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353055",
            "telephone_number": "918-392-4866",
            "fax_number": "918-392-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 S HARVARD AVE",
            "address_2": "SUITE 470",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353055",
            "telephone_number": "918-392-4866",
            "fax_number": "918-392-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER BENTON, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "918-392-4866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI# -TYPE I",
            "identifier": "1609927219",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.