Beverly Vistara Benoit, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC30928 Issued in CA

Practice address

175 Concourse Blvd
Santa Rosa, CA 95403-8217

Phone

(707) 284-9237

Fax

(707) 284-9254

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beverly Benoit Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Marriage and Family Therapist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780738518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CONCOURSE BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038217",
            "telephone_number": "707-284-9237",
            "fax_number": "707-284-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CONCOURSE BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038217",
            "telephone_number": "707-284-9237",
            "fax_number": "707-284-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENOIT",
        "first_name": "BEVERLY",
        "middle_name": "VISTARA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC30928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "MFC30928",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "BENOIT",
            "credential": "MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bennett Valley Icf DDH Inc
• Bennett Valley Union Elem
• David W. Bennett, MD
• Frederick S Bennett, M.D.
• Katharine Ashley Bennett
• David Anthony Benoit, MFT
• Elette Danielle Benoit
• Soheila Benrazavi, MD
• McKayla Bensley, CADC
• Laurel Diane Benson, LMFT

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.