Active NPI
Ben Reagan, PSY.D.
- Clinical Psychologist
- Lafayette, IN
National Provider Identifier
1659844611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20043159B
- Practice address
- 1201 Cumberland Ave
Lafayette, IN 47906-1359 - Phone
- (630) 777-8690
- NPI assigned
- Jan 2, 2019
- Last updated
- Jan 2, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20043159B | IN | Primary |
Addresses
Primary practice location
1201 Cumberland Ave
Lafayette, IN 47906-1359
Mailing address
927 Milky Way
Lafayette, IN 47905-4748
Phone (630) 777-8690
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20043159B | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546387200000",
"number": "1659844611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "927 MILKY WAY",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054748",
"telephone_number": "630-777-8690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 CUMBERLAND AVE",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479061359",
"telephone_number": "630-777-8690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGAN",
"first_name": "BEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-02",
"last_updated": "2019-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20043159B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.