Benjamin Greenberg, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004333 Issued in GA

Practice address

1221 S Saint Francis Dr Ste B
Santa Fe, NM 87505-4036

Phone

(505) 629-6853

Fax

(505) 372-6979

NPI assigned

Sep 16, 2015

Last updated

Jun 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dynamic Therapy Services of Northern New Mexico

  dba The Center for Dynamic Practice

  • Counseling Psychologist
  • Santa Fe, NM
  • NPI 1992418370
  NPD Authorized official
• The Center for Dynamic Practice

  • Health Service Psychologist
  • Santa Fe, NM
  • NPI 1518600048

  Clinical

  NPD Authorized official
• Pacific Center for Human Growth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1043434095
  NPD (past)
• Pacific Center for Human Growth

  • Community/Behavioral Health Agency
  • Berkeley, CA
  • NPI 1275687717
  NPD (past)

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1902275365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 VERANO LOOP",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875088827",
            "telephone_number": "505-629-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S SAINT FRANCIS DR STE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054036",
            "telephone_number": "505-629-6853",
            "fax_number": "505-372-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY1721",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004333",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John A Green III, MD
• Melissa Green
• Patricia Ellen Green, MA ., LPCC
• Paula Danette Green, MS, LCPC
• Sean Green
• Erin Michelle Greenspan, ND
• George Rushton Greer, M.D.
• Pamela Jean Gregg Flax, D.O.M.
• David Freeman Gregory, M.D.
• Michael E Gregory, MD

• Clinical Psychologist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.