Provider Demographics
NPI:1083718290
Name:BENSON, RICHARD LELAND (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LELAND
Last Name:BENSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8826 SANTA FE DR
Mailing Address - Street 2:STE 170
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-3655
Mailing Address - Country:US
Mailing Address - Phone:913-438-2100
Mailing Address - Fax:913-438-2119
Practice Address - Street 1:8826 SANTA FE DR
Practice Address - Street 2:STE 170
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3655
Practice Address - Country:US
Practice Address - Phone:913-438-2100
Practice Address - Fax:913-438-2119
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY01747103T00000X
KSLP1343103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO17459019OtherBLUE CROSS BLUE SHIELD
KS17459019OtherBLUE CROSS BLUE SHIELD
Q44444Medicare UPIN
MO000D853Medicare ID - Type Unspecified