Active NPI
Jeffrey Todd Benton, M.ED., ED.S.
- School Psychologist
- Suffolk, VA
National Provider Identifier
1962066159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 0813000142
- Practice address
- 200 Forest Glen Dr
Suffolk, VA 23434-6714 - Phone
- (757) 925-6764
- NPI assigned
- Apr 24, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 0813000142 | VA | Primary |
Addresses
Primary practice location
200 Forest Glen Dr
Suffolk, VA 23434-6714
Mailing address
100 North Main St PO Box 1549
Suffolk, VA 23434
Phone (757) 925-6764
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0813000142 | VA | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suffolk City Public Schools | 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.
-
- Local Education Agency (LEA)
- Suffolk, VA
- NPI 1003996083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1962066159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 NORTH MAIN ST PO BOX 1549",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "23434",
"telephone_number": "757-925-6764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 FOREST GLEN DR",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234346714",
"telephone_number": "757-925-6764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON",
"first_name": "JEFFREY",
"middle_name": "TODD",
"name_prefix": "Mr.",
"credential": "M.ED., ED.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "0813000142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.