Individual provider Active NPI

Kathryn P Benninghove

  • Mental Health Counselor
  • Sarasota, FL
National Provider Identifier
1699038703
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH6021 Issued in FL
Practice address
2033 Wood St
Sarasota, FL 34237-7900
Phone
(941) 677-3366
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH6021 FL Primary

Addresses

Primary practice location

2033 Wood St
Sarasota, FL 34237-7900

Mailing address

2033 Wood St
Sarasota, FL 34237-7900
Phone (941) 677-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240207001298 FL Practitioner - Mental Health Counselor 3971946914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center of Revitalizing Psychiatry, P.C.Group PAC ID 0648239988, 39 clinicians

Practice addresses (Care Compare)

2033 Wood St
Suite 220
Sarasota, FL 34237-7927
Phone (941) 677-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH6021FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Center of Revitalizing Psychiatry, P.C. CurrentSince Jan 1, 2024 Accepting new patients
Center of Revitalizing Psychiatry PC PastSince Jan 1, 2024 Accepting new patients

Locations

2033 Wood St
Ste 220
Sarasota, FL 34237
Phone (941) 677-3366

340 W Passaic St
Ste 1
Rochelle Park, NJ 07662
Phone (201) 488-5161

Interoperability endpoints

  • Direct secure messaging: kathrynbenninghove@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1699038703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-677-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-677-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNINGHOVE",
        "first_name": "KATHRYN",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.