Robert Winston Bennett Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17517 Issued in CA

Practice address

1380 Lead Hill Blvd
Ste. 110
Roseville, CA 95661-2941

Phone

(916) 556-4178

Fax

(916) 786-3080

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Hearthstone Counseling Services, Inc.

  • Clinical Psychologist
  • Roseville, CA
  • NPI 1891787644
  NPD (past) Authorized official

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1790777399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD",
            "address_2": "STE. 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-556-4178",
            "fax_number": "916-786-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD",
            "address_2": "STE. 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-556-4178",
            "fax_number": "916-786-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "middle_name": "WINSTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiare M Bendriss, PH.D.
• Benessere Marriage and Family Therapy, Inc
• Ranell Leigh Benfield
• Benjamin Van Pham
• Jessie Sophia Bennett, PA-C
• Timothy Paul Bennett, DDS
• Nicole Renee Bennington-McKay, MD
• Tarra Benoist
• Andre Tedrell Benson
• John Christopher Benson, DPM

• Clinical Psychologist in Roseville, CA
• Providers in Roseville, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.