Benjamin John Neeley, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60779123 Issued in WA

Practice address

1901 Main St
Washougal, WA 98671-4116

Phone

(360) 583-4900

NPI assigned

Jun 19, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Neeley Psychological Services, LLC

  • Psychologist
  • Washougal, WA
  • NPI 1376252973
  NPD Authorized official
• Duley Administrative Services, LLC

  • Clinic/Center
  • Washougal, WA
  • NPI 1487351888
  NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699205963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MAIN ST",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986714116",
            "telephone_number": "360-583-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MAIN ST",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986714116",
            "telephone_number": "360-583-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELEY",
        "first_name": "BENJAMIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60779551",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60779123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Diane Morales, M.A., LMHC
• Mount Pleasant School District
• Kristen Marie Moya, LMHC
• Nate Repta DMD PS
• Neeley Psychological Services, LLC
• Chris Neveux, CCC-SLP
• Corrine U Nightingale, CRC, NCC
• Jack Riley Olson
• Jeff Olson, L.AC., MACOM
• Orchard Hills Dental

• Psychologist in Washougal, WA
• Providers in Washougal, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.