Individual provider Active NPI

Lavonya Marie Bennett, PH.D.

  • Clinical Psychologist
  • Houston, TX
National Provider Identifier
1801469291
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38963 Issued in TX
Practice address
3355 West Alabama Ste 195
Houston, TX 77098-1722
Phone
(844) 824-8775
Fax
(281) 648-2200
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 03333 KS
Clinical Psychologist 103TC0700X 38963 TX Primary

Addresses

Primary practice location

3355 West Alabama Ste 195
Houston, TX 77098-1722

Mailing address

3355 West Alabama Ste 195
Houston, TX 77098-1722
Phone (844) 824-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
38963TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Clinical CurrentSince Jul 18, 2024 Accepting new patients

Locations

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

3355 W Alabama St
Ste 195
Houston, TX 77098
Phone (832) 895-6255

431 E State Highway 114
Ste 140
Southlake, TX 76092
Phone (817) 751-7802

Organizations & group practices 1

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": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1801469291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 WEST ALABAMA STE 195",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981722",
            "telephone_number": "844-824-8775",
            "fax_number": "281-684-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 WEST ALABAMA STE 195",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981722",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LAVONYA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "03333",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.