Active NPI
Breena Benefield
- Child Mental Illness Respite Care
- Waddell, AZ
National Provider Identifier
1912072448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Mental Illness Respite Care
- License
- 11346
- Practice address
- 18357 W Beryl CT
Waddell, AZ 85355-4355 - Phone
- (623) 977-9484
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Mental Illness Respite Care | 385HR2055X | 11346 | AZ | Primary |
Addresses
Primary practice location
18357 W Beryl CT
Waddell, AZ 85355-4355
Mailing address
18357 W Beryl CT
Waddell, AZ 85355-4355
Phone (623) 977-9484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113717 | Other | AZ | AHCCCS ID NUMBER |
Other names 1
- Chris Welz
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11346 | AZ | MD | Child Mental Illness Respite Care |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Devereux Foundation | Past | Accepting new patients |
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Phoenix, AZ
- NPI 1306939368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193270400000",
"number": "1912072448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18357 W BERYL CT",
"city": "WADDELL",
"state": "AZ",
"postal_code": "853554355",
"telephone_number": "623-977-9484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18357 W BERYL CT",
"city": "WADDELL",
"state": "AZ",
"postal_code": "853554355",
"telephone_number": "623-977-9484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENEFIELD",
"first_name": "BREENA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2007-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": "AZ",
"license": "11346",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS ID NUMBER",
"identifier": "113717",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRIS",
"last_name": "WELZ",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Waddell, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.