| Rachel Benjamin Psyd Licensed Psychologist Pllc | |
|
17138 Alta Vista Dr Southfield MI 48075-1981 | |
| (248) 952-8116 | |
| Not Available |
| Full Name | Rachel Benjamin Psyd Licensed Psychologist Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17138 Alta Vista Dr, Southfield, Michigan |
| Authorized Official Name and Position | Rachel Benjamin (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2489528116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rachel Benjamin Psyd Licensed Psychologist Pllc 15900 W 10 Mile Rd Ste 211 Southfield MI 48075-2079 Ph: (248) 952-8116 | Rachel Benjamin Psyd Licensed Psychologist Pllc 17138 Alta Vista Dr Southfield MI 48075-1981 Ph: (248) 952-8116 |
| NPI Number | 1104525658 |
|---|---|
| Provider Enumeration Date | 02/23/2023 |
| Last Update Date | 02/23/2023 |
| Certification Date | 02/23/2023 |
| Medicare PECOS PAC ID | 1658746201 |
|---|---|
| Medicare Enrollment ID | O20230412002148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104525658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Rachel Benjamin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073229027 PECOS PAC ID: 2567837115 Enrollment ID: I20230412002482 |
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