Individual provider Active NPI

Elysia Benedict, PH.D.

  • Clinical Psychologist
  • Wynnewood, PA
National Provider Identifier
1881084523
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS018174 Issued in PA
Practice address
100 E Lancaster Ave Ste 161
Wynnewood, PA 19096-3427
Phone
(484) 284-1966
Fax
(610) 595-9724
NPI assigned
Feb 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS018174 PA
Clinical Psychologist 103TC0700X B1-0001051 DE
Clinical Neuropsychologist 103G00000X B1-0001051 DE
Clinical Psychologist 103TC0700X PS018174 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave Ste 161
Wynnewood, PA 19096-3427

Mailing address

105 Rutgers Ave Unit 420
Swarthmore, PA 19081-2242
Phone (484) 442-0141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 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
I20160322000165 DE Practitioner - Clinical Psychologist 1052618923 Practice locations: Newark, DE
I20190611002591 PA Practitioner - Clinical Psychologist 1052618923 Practice locations: Wynnewood, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 E Lancaster Ave
Suite 161E
Wynnewood, PA 19096-3427
Phone (484) 284-1966

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1881084523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RUTGERS AVE UNIT 420",
            "city": "SWARTHMORE",
            "state": "PA",
            "postal_code": "190812242",
            "telephone_number": "484-442-0141",
            "fax_number": "610-595-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 161",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963427",
            "telephone_number": "484-284-1966",
            "fax_number": "610-595-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "ELYSIA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS018174",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0001051",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "DE",
            "license": "B1-0001051",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.