Individual provider Active NPI

Ben Hao Wu, PHD

  • Counseling Psychologist
  • Jackson, MS
National Provider Identifier
1689207128
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY.0005202 Issued in CO
Practice address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone
(601) 362-4471
NPI assigned
Feb 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY.0005202 CO Primary

Addresses

Primary practice location

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116

Mailing address

247 Clark Farms Rd
Madison, MS 39110-8115
Phone (415) 312-9324

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY.0005202COMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1689207128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CLARK FARMS RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108115",
            "telephone_number": "415-312-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "BEN",
        "middle_name": "HAO",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "PSY.0005202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.