DR. BENJAMIN JOSEPH RICHTER (NPI# 1053658377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053658377 |
Entity Type | Individual |
Full Name | DR. BENJAMIN JOSEPH RICHTER |
Credential | PSY.D. |
Practice Address |
515 Ne Glen Oak Ave Suite 101 Peoria IL 61637-3167 |
Practice Telephone | 3096557378 |
Practice Fax Number | 3096554609 |
Mailing Telephone | 3096557378 |
Mailing Fax Number | 3096554609 |
Enumeration Date | 2013-01-07 |
Last Update Date | 2013-08-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 071.008614 | IL | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
4350 | AZ | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386263630 | Benjamin Ian Richter | Student in an Organized Health Care Education/Training Program | 550 1st Ave, New York, NY 10016-6402 | 2020-04-15 |
1376989608 | Benjamin Edwin Richter | Pharmacy Technician | 1212 E Shelby Dr, Memphis, TN 38116-7124 | 2013-05-14 |
Street Address |
515 NE GLEN OAK AVE SUITE 101 |
City | PEORIA |
State | IL |
Zip Code | 61637-3167 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174596225 | University of Illinois | Pediatrics | 515 Ne Glen Oak Ave, Pediatric Neurology, Peoria, IL 61603-3165 | 2006-02-09 |
1528614484 | Jordan Mark Czajka | Physician Assistant | 515 Ne Glen Oak Ave, Peoria, IL 61603-3136 | 2019-08-15 |
1689061251 | Caleb Davis | Counselor | 515 Ne Glen Oak Ave, Suite 101, Peoria, IL 61603-3136 | 2015-04-22 |
1457770646 | Daniel M Couri Ltd | Internal Medicine | 515 Ne Glen Oak Ave, Suite 105, Peoria, IL 61603-3136 | 2014-04-15 |
1457576688 | Robert A Pflederer | Internal Medicine | 515 Ne Glen Oak Ave, Suite 108, Peoria, IL 61603-3136 | 2007-04-14 |
1043236573 | Patresa R Brager | Psychologist | 515 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-07-15 |
1295704468 | Blas Zelaya | Pediatrics | 515 Ne Glen Oak Ave, Pediatric Neurology #308, Peoria, IL 61603-3165 | 2006-03-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
Find all providers in zip 61637 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174927172 | Christopher Simpson | Clinical Neuropsychologist | 10184 W Happy Valley Rd, Suite 190, Peoria, AZ 85383-1254 | 2014-10-20 |
1891800603 | Shanna Marie Kurth | Clinical Neuropsychologist | 3100 N Dries Ln, Ste 303, Peoria, IL 61604-1265 | 2006-08-20 |
1003425786 | Brycie Weiden | Clinical Neuropsychologist | 515 Ne Glen Oak Ave Ste 101, Peoria, IL 61603-3167 | 2020-07-28 |
1649723990 | Eric Aune | Clinical Neuropsychologist | 530 Ne Glen Oak Ave, Children's Hospital of Illinois, Peoria, IL 61637-0001 | 2016-08-03 |
1740459429 | Amy Serin | Clinical Neuropsychologist | 10200 W Happy Valley Rd, Suite A135, Peoria, AZ 85383-2878 | 2008-02-26 |
1659553444 | Neuropsychology Clinic PC | Clinical Neuropsychologist | 3100 N Dries Ln, Ste 303, Peoria, IL 61604-1265 | 2007-12-04 |
1659396505 | Michele R. Verda | Clinical Neuropsychologist | 420 Ne Glen Oak Ave, 401, Peoria, IL 61603-3105 | 2006-07-13 |
1962456764 | Saint Francis Medical Center | Clinical Neuropsychologist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-05-19 |
1831181726 | Dietra Duffala Teichmann | Clinical Neuropsychologist | 5401 N Knoxville Ave, Suite 217, Peoria, IL 61614-5098 | 2005-08-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477183556 | Michelle Yvonne Kibby-faglier | Clinical Neuropsychologist | 285 Lake Indian Hills Dr, Carbondale, IL 62902-6184 | 2020-01-17 |
1003456708 | David Jackson | Clinical Neuropsychologist | 6 Parkway North Blvd, Deerfield, IL 60015-2522 | 2020-01-10 |
1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
1043877475 | Sarah Mailander Dyer | Clinical Neuropsychologist | 900 Royal Heights Rd Ste 14, Belleville, IL 62226-5457 | 2019-05-21 |
1639655632 | Julia Digangi | Clinical Neuropsychologist | 920 N York Rd, Hinsdale, IL 60521-2996 | 2018-07-13 |
1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
1538690466 | Kathleen Ares | Clinical Neuropsychologist | 4440 W 95th, Suite 1200h, Oak Lawn, IL 60453 | 2017-03-22 |
1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
1013462829 | Ann Westcot Jordan | Clinical Neuropsychologist | 21037 Benjamin Dr, Shorewood, IL 60404-0612 | 2016-08-22 |
1740638915 | Elizabeth Regina Tuminello Hartman | Clinical Neuropsychologist | 1875 Dempster St Ste 520, Park Ridge, IL 60068-1130 | 2016-05-29 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.