Elizabeth L. Bennett, ED.D.

Key facts

NPI

1821155987

Entity type

Individual (NPI type 1)

Primary specialty

Counseling Psychologist 103TC1900X

License

6683 (MA)

Practice address

78 Middle St
Fairhaven, MA 02719-3050

Phone

(508) 994-9574

NPI assigned

Jan 1, 2007

Sex

Female

Sole proprietor

Yes

Medicare Care Compare profile

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 19, 2020.

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1821155987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HAWTHORN ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403429",
            "telephone_number": "508-994-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 MIDDLE ST",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027193050",
            "telephone_number": "508-994-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ELIZABETH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "6683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W05418",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "279136000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhaven, MA

• Chester Thomas Baron, D.C.
• Michael L Barretti Jr., DO
• Fay R Bartling I, RN, LMHC, LADAC1
• Rachael Bednarz-Medeiros, DO
• Behavioral Connections
• Anick Bernier, PT
• Bio-Medical Applications of Massachusetts, Inc.
• Gina Louise Biscaia, PHARMD
• Leanne M. Bishop, PT
• Elizabeth M Blanchard, MD

All providers in Fairhaven, MA · Counseling Psychologist in Massachusetts