Active NPIIndividual providerSole proprietor

Dr. Benny S Willis, PHD

Psychologist, Clinical Child & Adolescent in Arlington, Massachusetts

NPI Number1407905995
Practice location
691 Massachussets Avenue, Suite 10, Arlington, MA 02479-1648
Fax
—
Last updated
November 25, 2015

Benny S Willis is a Psychologist, Clinical Child & Adolescent based in Arlington, MA. Benny S Willis practices in Arlington, MA and has the professional credentials of PHD. The NPI Number for Benny S Willis is 1407905995 and holds a License No. 6244 (MA). The current practice location address for Benny S Willis is 691 Massachussets Avenue, Suite 10, Arlington, MA 02479-1648 and can be reached out via phone at 617-242-4228.

Provider Profile Details

NPI Number
1407905995
Provider Name
Benny S Willis
Credential
PHD
Provider Entity Type
Individual
Gender
Male
Address
691 Massachussets Avenue, Suite 10, Arlington, MA 02479-1648
Phone Number
617-242-4228
Primary Taxonomy
Psychologist, Clinical Child & Adolescent · 103TC2200X
Sole Proprietor
Yes
Other Names
Dr. B Steven Willis, PHD (Professional Name)
Provider Enumeration Date
January 10, 2007
Last Update Date
November 25, 2015
NPI Status
Active

Provider Business Practice Location Address Details

Address
691 Massachussets Avenue
Suite 10
Arlington, MA 02479-1648
Zip
02479-1648
Phone Number
617-242-4228
Arlington, MA 02479Get directions →

Provider Business Mailing Address Details

Address
691 Massachussets Avenue
Suite 10
Arlington, MA 02479-1648
City
Arlington
State
MA
Zip
02479-1648
Phone Number
617-242-4228

License Information

License Number (1)
6244
License State (1)
MA
Taxonomy (1)
Psychologist, Cognitive & Behavioral · 103TB0200X
License Number (2)
6244
License State (2)
MA
Taxonomy (2)
Psychologist · 103T00000X
License Number (3)
6244
License State (3)
MA
Taxonomy (3)
Psychologist, Clinical Child & Adolescent · 103TC2200X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Dr. Benny S Willis, PHD?

The NPI number of Dr. Benny S Willis, PHD is 1407905995. It was assigned on January 10, 2007 and is currently active in the NPPES registry.

What is the specialty of Dr. Benny S Willis, PHD?

Dr. Benny S Willis, PHD is registered under the primary taxonomy Psychologist, Clinical Child & Adolescent (code 103TC2200X), licensed in MA under license number 6244.

Where does Dr. Benny S Willis, PHD practice?

The practice location is 691 Massachussets Avenue, Suite 10, Arlington, MA 02479-1648. The office can be reached at 617-242-4228 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1407905995 directly on the NPPES registry website.

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