Individual provider Active NPI

Donna Lynn Benjamin, PSY.D., LCSW

  • Clinical Psychologist
  • Twin Falls, ID
National Provider Identifier
1811289226
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2261372 Issued in ID
Practice address
815 N College Rd
Twin Falls, ID 83301-3484
Phone
(208) 814-9100
NPI assigned
May 4, 2011
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS1388 ME
Clinical Psychologist 103TC0700X 2261372 ID Primary
Clinical Social Worker 1041C0700X LC5889 ME

Addresses

Primary practice location

815 N College Rd
Twin Falls, ID 83301-3484

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230607003161 VA Practitioner - Clinical Psychologist 6800065483 Reassigns benefits to 1 organization
I20250606001038 ID Practitioner - Clinical Psychologist 6800065483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

746 N College Rd
Twin Falls, ID 83301-3486

815 N College Rd
Twin Falls, ID 83301-3484
Phone (208) 814-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS1388MEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia South Psychiatric & Family Services CurrentSince May 4, 2023 Accepting new patients
St Luke's Clinic LLC CurrentSince Mar 21, 2025 Accepting new patients
Three Rivers Treatment Center LLC PastSince May 4, 2023 Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD PastSince Sep 15, 2024 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

815 N College Rd
Twin Falls, ID 83301
Phone (208) 814-9903

269 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 861-0700

Interoperability endpoints

  • Direct secure messaging: commonwealthcounselingassociates.donnabenjamin@134000.advancedmd-direct.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1811289226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N COLLEGE RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013484",
            "telephone_number": "208-814-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1388",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "2261372",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.