DR. PHILLIP CHARLES BENNETT (NPI# 1205050978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205050978 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP CHARLES BENNETT |
| Credential | PH.D. |
| Practice Address |
2401 Pennsylvania Ave Suite 1c-51 Philadelphia PA 19130-3010 |
| Practice Telephone | 2154969091 |
| Practice Fax Number | 2159516273 |
| Mailing Telephone | 2154969091 |
| Mailing Fax Number | 2159516273 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-06-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PS008447L | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194143560 | Phillip Bennett | Contractor | Psc 482 Box 2620, Fpo, AP 96362-2699 | 2014-04-02 |
| 1356695837 | Phillip Bennett | Pharmacist | 1408 West Broad St Su 2, The Medicine Shoppe, Quakertown, PA 18951 | 2012-11-05 |
| 1235766627 | Phillip Marshall Bennett | Student in an Organized Health Care Education/Training Program | 500 S Chipeta Way, Salt Lake City, UT 84108-1221 | 2020-03-25 |
| 1629223730 | Phillip Whayne Bennett | Social Worker | 146 Pike Street, Port Jervis, NY 12771 | 2008-11-18 |
| Street Address |
2401 PENNSYLVANIA AVE SUITE 1C-51 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19130-3010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154958742 | Dennis Michael Czerw | Pharmacy | 2401 Pennsylvania Ave, Philadelphia, PA 19130-3010 | 2020-03-24 |
| 1184101388 | Nikki James | Pharmacist | 2401 Pennsylvania Ave, Philadelphia, PA 19130-3010 | 2018-07-20 |
| 1174032916 | Elizabeth Paige Diamond | Marriage & Family Therapist | 2401 Pennsylvania Ave, 1a2, Philadelphia, PA 19130 | 2017-09-25 |
| 1083155253 | Agnes Tinker | Speech-Language Pathologist | 2401 Pennsylvania Ave, Apt. 12b33, Philadelphia, PA 19130-3010 | 2017-03-20 |
| 1710363437 | Jennifer Lynn Grau | Physical Therapist | 2401 Pennsylvania Ave, Suite 1d5, Philadelphia, PA 19130-3010 | 2015-08-04 |
| 1306263918 | Barry Sukoneck | Dentist | 2401 Pennsylvania Ave, Suite 1a8, Philadelphia, PA 19130-3010 | 2014-03-20 |
| 1457792236 | Shu-zhen Kuang | Dentist | 2401 Pennsylvania Ave, Suite 1 A8, Philadelphia, PA 19130-3010 | 2013-07-09 |
| 1164768800 | Ann Itzkowitz | Psychologist | 2401 Pennsylvania Ave, Suite 1a4, Philadelphia, PA 19130-3010 | 2012-12-28 |
| 1710231915 | New Image & Wellness | Chiropractor | 2401 Pennsylvania Ave, Suite 1 A2, Philadelphia, PA 19130-3010 | 2012-11-09 |
| 1629340401 | Nancy Yaros | Podiatrist | 2401 Pennsylvania Ave, 4a5, Philadelphia, PA 19130-3010 | 2012-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1689213456 | Nora Marie Corbett | Physical Therapist | 1714 Fairmount Avenue, Philadelphia, PA 19130 | 2019-12-27 |
| 1104470665 | Thibault Counseling LLC | Clinic/Center | 2049 North Street, Philadelphia, PA 19130 | 2019-08-01 |
| 1619444577 | Rebecca Boova | Dietitian, Registered | 1644 Francis St, #3, Philadelphia, PA 19130 | 2018-10-30 |
| 1184191108 | Sharon Marie Thompson | Nurse Practitioner | School District of Philadelphia/school Health Services, 440 North Broad Street, Philadelphia, PA 19130 | 2018-10-29 |
| 1861918542 | Theresa Mary Thompson | Dental Hygienist | Delaware Valley Community Health, 1412 Fairmount Avenue, Philadelphia, PA 19130 | 2017-08-15 |
| 1023539806 | Marina France | Social Worker | 2401 Pennsylvania Ave Ste 1a2, Philadelphia, PA 19130 | 2017-06-30 |
| 1619425063 | Sarah Nash | Dietitian, Registered | 420 North 20th Street, Philadelphia, PA 19130 | 2016-09-14 |
| 1154737757 | Julia Ferrence | Social Worker | 2305 Fairmount Avenue, Philadelphia, PA 19130 | 2014-07-03 |
| 1811319924 | Larry H Goldberg | Internal Medicine | 2441 Olive Street, Philadelphia, PA 19130 | 2014-01-08 |
| Find all providers in zip 19130 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578937 | Margaret Edwards | Psychologist | 110 S 20th St Ste 206, Philadelphia, PA 19103-4486 | 2020-11-03 |
| 1699374843 | Elizabeth Ann Johnson | Psychologist | 3640 Stanton St Apt 107, Philadelphia, PA 19129-1683 | 2020-10-20 |
| 1689272577 | Katherine Piselli | Psychologist | 3401 Market St Ofc 3216, Philadelphia, PA 19104-3318 | 2020-10-13 |
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1659980621 | Corinne Masur | Psychologist | 1601 Walnut St Ste 1408, Philadelphia, PA 19102-2909 | 2020-07-27 |
| 1730798067 | Amanda Marie Large | Psychologist | 1516 N 5th St Unit 401, Philadelphia, PA 19122-3679 | 2020-07-22 |
| 1295355543 | Jennifer Ann Engelhardt | Psychologist | 8201 Henry Ave Apt Q15, Philadelphia, PA 19128-2248 | 2020-04-16 |
| 1336778315 | Carly Mirit Gerbi | Psychologist | 2227 Delancey Pl, Philadelphia, PA 19103-6549 | 2020-04-02 |
| 1811530512 | Tower Drexel Academic Medical Group LLC | Psychologist | 1427 Vine St Fl 1, Philadelphia, PA 19102-1031 | 2019-10-25 |
| 1003459702 | Tower Drexel Academic Medical Group LLC | Psychologist | 4700 Wissahickon Ave Ste C102, Philadelphia, PA 19144-4248 | 2019-10-25 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19130 |
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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.