Individual provider Active NPI

Amanda Tanner Benson, PSY.D.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1740473529
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016322 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-9434
NPI assigned
Aug 24, 2007
Last updated
Feb 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS016322 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-9434

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS016322PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yapa Group Therapy, Inc. Clinical Past Accepting new patients
Dresher Treatment Group Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1740473529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "AMANDA",
        "middle_name": "TANNER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.